Impact of a clinical decision support system on adherence to clinical guidelines in the management of patients with heart failure (SPHERA-HF study)
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim . To assess the impact of a clinical decision support system (CDSS) aimed at increasing physician compliance with clinical guidelines on heart failure (HF) in real-world practice in order to improve the effectiveness of managing this category of patients and clinical outcomes in pilot Russian regions. Material and methods . As part of the retrospective multicenter study SPHERA-HF, data of electronic health records from 49 medical facilities in three Russia regions were analyzed. The study participants were divided into inpatient and outpatient cohorts. The main inclusion criterion was a history of HF diagnosis. The features of patient management in real-world practice were studied before and after the implementation of the CDSS. Results. The study included 66166 patients. After CDSS imple neprilysin inhibitors in patients with HF with reduced ejection fraction increased in the in-hospital cohort from 32,9% to 52,3% (p<0,05); in the outpatient cohort from 24,2% to 45,3% (p<0,05). There was an increase in the prescription rate of quadruple therapy at discharge in the inhospital cohort from 22,3% to 32,6% (p<0,05); at the initiation visit in the outpatient cohort from 24,6% to 42,9% (p<0,05). There was a decrease in the number of rehospitalizations for cardiovascular diseases in the inhospital cohort from 26,9% to 20,1% (p<0,05). Conclusion. The study results indicate a positive impact of CDSS introduction on managing patients with HF.
Authors: S. N. Tereshchenko, I. V. Zhirov, A. M. Shangina, F. N. Paleev, S. A. Boytsov, A. E. Uranov, K. S. Astrakova, I. L. Mikheenko, A. A. Gartung, A. A. Spiridonov, Y. S. Krivosheev, I. I. Shestova, D. S. Markov, I. L. Strokolskaya, O. L. Barbarash, M. A. Meshkova, I. A. Starodubtseva, N. A. Gurina, V. A. Petrakovskaia
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413293609