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Monitoring and improving guideline adherence by an electronic decision support system.


- candidate number1426
- NTR NumberNTR246
- ISRCTNISRCTN36656997
- Date ISRCTN created20-dec-2005
- date ISRCTN requested18-okt-2005
- Date Registered NTR7-sep-2005
- Secondary IDsN/A 
- Public TitleMonitoring and improving guideline adherence by an electronic decision support system.
- Scientific TitleMonitoring and improving guideline adherence by an electronic decision support system: a multicenter cluster randomised trial.
- ACRONYMCARDSS
- hypothesisCare providers are more likely to adhere to clinical practice guidelines when they receive guideline-based decision support by an electronic system.
- Healt Condition(s) or Problem(s) studiedHeart diseases, Cardiac rehabilitation
- Inclusion criteriaThe decision support system (DSS) can be used at all Dutch cardiac rehabilitation (CR) centres. These centres treat patients after acute coronary syndromes, patients with angina pectoris, heart failure, and/or congenital heart disease, and patients who have undergone cardiac surgery, percutaneous transluminal coronary angioplasty, or heart transplant surgery, or have received an implantable cardioverter defibrillator.
- Exclusion criteriaThe system should be used on a routine basis in the participating CR centres, for all patients that are screened for CR; no patients are excluded.
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingNone
- controlActive
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-jan-2005
- planned closingdate1-jan-2006
- Target number of participants5000
- InterventionsRandomisation takes place at cluster (centre) level. The participating cardiac rehabilitation centres will either work with an intervention version of the DSS, having full functionality with advice, or with a control version, which comprises patient records and information management services but provides no advice regarding clinical decisions.
The system is based on the Dutch Cardiac Rehabilitation Guidelines 2004.
- Primary outcomeAdherence, by care providers, to the Dutch Cardiac Rehabilitation Guidelines.
- Secondary outcomeN/A
- TimepointsN/A
- Trial web sitehttp://www.cardss.nl
- statusstopped: trial finished
- CONTACT FOR PUBLIC QUERIESDr. N. Peek
- CONTACT for SCIENTIFIC QUERIESDr. N. Peek
- Sponsor/Initiator Dutch Heart Foundation
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development
- PublicationsStud Health Technol Inform. 2008;136:193-8.
- Brief summaryCardiac rehabilitation is a multidisciplinary therapy for cardiac patients that is provided after cardiac events and cardiac interventions. It is optimally effective in a patient-oriented approach where each rehabilitation programme is tailored to the patient's specific needs; this approach is therefore advocated by the Dutch Guidelines Cardiac Rehabilitation.
To support professionals in applying the guidelines in daily practice, an electronic decision support system (DSS) has been developed that is based on the guidelines.
The DSS identifies the appropriate goals and therapies of a cardiac rehabilitation programme, based on the patient's condition, history, and needs.
This study evaluates the effect of the DSS on guideline adherence by conducting a cluster randomised trial. The participating cardiac rehabilitation centres will either work with an intervention version of the DSS, having full functionality, or with a control version, which comprises patient records and information management services but provides no decision support. Both versions of the DSS record patient data, guideline-based recommendations, and rehabilitation goals and therapies that are actually pursued in each patient's programme. Duration of the trial is six months in each participating CR centre.
- Main changes (audit trail)
- RECORD7-sep-2005 - 16-okt-2008


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