Optimizing compliance with clinical guidelines using a clinical decision support system in patients with hypertension and atrial fibrillation in real-world practice: a cluster-randomized comparative study INTELLECT-2

Aim . To evaluate the impact of a clinical decision support system (CDSS) in the management of patients with hypertension (HTN) and atrial fibrillation (AF) on compliance with clinical guidelines in real-world clinical practice. Material and methods. A cluster-randomized comparative study was conducted in 8 internal medicine departments in Samara. The departments were randomized into two following groups: one with the CDSS for prescribing anticoagulant, antiarrhythmic, and antihypertensive therapy (n=3; 2 inpatient and 1 outpatient department) and one without the CDSS — routine clinical practice (n=5; 3 inpatient and 2 outpatient departments). The study included patients with both hypertension and AF. The mean follow-up period was 11,5±5,7 months. R e sults . The study included 272 patients. Prescription rate of reduced doses of direct oral anticoagulants was significantly lower in the CDSS group as follows: apixaban 2,5 mg (0,8% vs 4,4%, p