Clinical Decision Support May Aid CV Health in Mental Illness

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For patients with serious mental illness, a clinical decision support system aimed at primary care clinicians may reduce the rate of increase in CV risk.

HealthDay News — For patients with serious mental illness (SMI), a clinical decision support (CDS) system aimed at primary care clinicians may modestly reduce the rate of increase in total modifiable cardiovascular (CV) risk, according to a study published online March 7 in JAMA Network Open.

Rebecca C. Rossom, M.D., from HealthPartners Institute in Minneapolis, and colleagues randomly assigned 76 primary care clinics in three Midwestern health care systems to receive or not receive a CDS system (42 intervention clinics; 34 control clinics) aimed at improving CV health among 8,937 patients with SMI. Patient-level change in total modifiable CV risk over 12 months was examined as the main outcome measure.

The researchers found that compared with control patients, intervention patients had a 4 percent lower rate of increase in total modifiable CV risk (relative rate ratio [RR], 0.96). The intervention favored patients aged 18 to 29 years or 50 to 59 years (RR, 0.89 and 0.93, respectively) and Black or White patients (RR, 0.93 and 0.96, respectively). Men and women benefitted from the intervention (RR, 0.96 and 0.95, respectively), as did patients with all SMI subtypes (RRs, 0.96, 0.94, and 0.92 for bipolar disorder, schizoaffective disorder, and schizophrenia, respectively). No significant differences were seen between the groups in individual modifiable risk factors.

“Our finding of a 4 percent relative decrease in modifiable CV risk in intervention compared with control patients was modest yet clinically significant, particularly given the relatively low intensity of the intervention and the intention-to-treat analysis,” the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

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