Clinical decision support systems could be a promising tool to help clinicians control hypertension in patients with chronic kidney disease.
The addition of a clinical decision support tool improved the systolic blood pressure among patients with chronic kidney disease andprescribed blood pressure medication and ordered basic metabolic labs more often than physicians who didn't use the tool, according to a new study"Many primary care physicians don't have hypertension on the top of their list despite it being a key risk factor for adverse outcomes" in patients with chronic kidney disease, said Lipika Samal, MD,...
Patients were included in the study if they had stage III or IV chronic kidney disease and uncontrolled hypertension, defined as one reading of an SBP > 140 mm Hg taken within the previous 2 years with a primary care clinician. Approximately 1000 patients were in each arm, and clinicians were randomly assigned to use the intervention or to practice usual care . The median age of patients was 75.3 years, 60.4% were female, and almost three fourths of patients were White.
While the intervention did not result in a significant difference between groups in the percentage of patients who achieved blood pressure control (50.4% vs 47.1%;The intervention group experienced a 14.6-point drop in their SBP, compared with an 11.7-mm Hg drop among patients receiving usual care (Clinicians in the intervention group also ordered more basic metabolic panels, and more patients in the intervention group received a prescription order for a first-line renoprotective agent (24.
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