Impact of a clinical decision support system on adherence to clinical guidelines in the management of patients with heart failure (SPHERA-HF study)

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.

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Publication Details

Journal
CARDIOVASCULAR THERAPY AND PREVENTION
Published
2025-08-17
DOI
https://doi.org/10.15829/1728-8800-2025-4462
Primary Topic
Heart Failure Treatment and Management
Type
article
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article

Impact of a clinical decision support system on adherence to clinical guidelines in the management of patients with heart failure (SPHERA-HF study)

A. M. Shangina, О. Л. Барбараш, Yu. S. Krivosheev, K. S. Benimetskaya et al.
CARDIOVASCULAR THERAPY AND PREVENTION
Heart Failure Treatment and Management
article

Impact of a clinical decision support system on adherence to clinical guidelines in the management of patients with heart failure (SPHERA-HF study)

A. M. Shangina, О. Л. Барбараш, Yu. S. Krivosheev, K. S. Benimetskaya, I. Mikheenko, И. В. Жиров, I. L. Strokolskaya, I. Starodubtseva, I.I. Shestova, С. Н. Терещенко, В. А. Петраковская, Allison Gartung, Ф. Н. Палеев, Natalia Gurina, A. A. Spiridonov, D. S. Markov, S. А. Boytsov, A. E. Uranov, M. А. Meshkova
article en

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.

CARDIOVASCULAR THERAPY AND PREVENTIONVol. 24(7)
Voronezh State Medical Academy named after N.N. Burdenko (RU), Government of the United States of America (US), Novartis (Netherlands) (NL), Medication Management (United States) (US), Guz "Tul'skiy Oblastnoy Onkologicheskiy Dispanser (RU), Regional Children's Clinical Hospital No. 1 (RU), National Medical Research Center of Cardiology (RU), State Healthcare Institution "Regional Clinical Oncological Dispensary" (RU), Kemerovo State University (RU)
Openalex Percentile: Top 66%
Heart Failure Treatment and Management
DOIOpen Access PDFOpenAlex
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