Holt, Tim A., Thorogood, Margaret, Griffiths, Frances, Munday, Stephen, Friede, Tim and Stables, David. (2010) Automated electronic reminders to facilitate primary cardiovascular disease prevention : randomised controlled trial. British Journal of General Practice, Vol.60 (No.573). e137-e143. ISSN 0960-1643

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Abstract

Background: Primary care databases contain cardiovascular disease risk factor data, but practical tools are required to improve identification of at-risk patients. Aim: To test the effects of a system of electronic reminders (the 'e-Nudge') on cardiovascular events and the adequacy of data for cardiovascular risk estimation. Design of study: Randomised controlled trial. Setting: Nineteen general practices in the West Midlands, UK. Method The e-Nudge identifies four groups of patients aged over 50 years on the basis of estimated cardiovascular risk and adequacy of risk factor data in general practice computers. Screen messages highlight individuals at raised risk and prompt users to complete. risk profiles where necessary. The proportion of the study population in the four groups was measured, as well as the rate of cardiovascular events in each arm after 2 years. Results: Over 38 000 patients' electronic records were randomised. The intervention led to an increase in the proportion of patients with sufficient data who were identifiably at risk, with a difference of 1.94% compared to the control group (95% confidence interval [CI] = 1.38 to 2.50, P<0.001). A corresponding reduction occurred in the proportion potentially at risk but requiring further data for a risk estimation (difference = -3.68%, 95% CI = -4.53 to -2.84, P<0.001). No significant difference was observed in the incidence of cardiovascular events (rate ratio = 0.96, 95% CI = 0.85 to 1.10, P = 0.59). Conclusion: Automated electronic reminders using routinely collected primary care data can improve the adequacy of cardiovascular risk factor information during everyday practice and increase the visibility of the at-risk population.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cardiovascular system -- Diseases -- Prevention, Cardiovascular system -- Diseases -- Risk factors, Health risk assessment, Medical informatics, Primary care (Medicine) -- Databases
Journal or Publication Title:	British Journal of General Practice
Publisher:	Royal College of General Practitioners
ISSN:	0960-1643
Date:	April 2010
Volume:	Vol.60
Number:	No.573
Number of Pages:	7
Page Range:	e137-e143
Identification Number:	10.3399/bjgp10X483904
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	University of Warwick
URI:	http://wrap.warwick.ac.uk/id/eprint/5790

Data sourced from Thomson Reuters' Web of Knowledge

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