ABSTRACT
Aim To evaluate prescription of lipid-lowering and antithrombotic therapy in clinical practice and to compare differences in recommendations using the clinical decision support service (CDSS).Material and methods Electronic medical records (EMR) of 300 patients from the Chazov National Medical Research Center of Cardiology, as well as from medical organizations controlled by the Department of Health of the Lipetsk Region and the Ministry of Health of the Voronezh Region, were analyzed for the period of August - December 2022, during the pilot implementation of CDSS. Retrospective information about the prescription of lipid-lowering and antithrombotic therapy from the EMR was compared with the CDSS guidelines under the expert supervision based on digitized clinical and laboratory profiles of patients. The study primary endpoint was a change in the initially prescribed lipid-lowering andâ/âor antithrombotic therapy as per CDSS guidelines.Results Overall 292 patients were included in the final analysis; 46 (15.7â%) were from the primary prevention group and 246 (84.3â%) from the secondary prevention group. In group 1, the lipid-lowering therapy recommended by the CDSS differed by 50â% (p<0.001) from the baseline therapy recorded in the EMR. In the secondary prevention group, 78.9â% (p<0.001) differences were found in the lipid-lowering therapy recommended in the CDSS guidelines compared to the prescriptions in the EMR. In 76.8â% (p<0.001) of patients, antithrombotic therapy was significantly different from the baseline therapy in the EMR.Conclusion The use of CDSS may improve the practice of choosing lipid-lowering and antithrombotic therapy for prevention of cardiovascular complications.
Subject(s)
Decision Support Systems, Clinical , Electronic Health Records , Humans , Retrospective Studies , Platelet Aggregation Inhibitors , Fibrinolytic Agents , LipidsABSTRACT
Background: Currently, several studies are available on the effective use of the Instagram social media platform to conduct training projects for CVD patients. The aim of this study was to determine the most effective methods (text or video) of informing people about the primary prevention of hypertension using a social media website. Materials and methods: A total of 125 participants were randomly selected and assigned to one of the four training groups depending on the training mode, i.e. text posts (4000 characters) - Group 1, video clips (5 min) - Group 2, text followed by video - Group 3 and video followed by text - Group 4. Before and after training, respondents in all four groups completed the Heart Disease Knowledge Questionnaire (HDKQ). Results: The total number of people who listened to and read the materials of the online school was 2108 people. Before training, the number of correct responses for 29 HDKQ statements was 18.4 ± 5.1, after training it increased to 21.9 ± 3.9 (CI, 21; 22.7) (p < 0.0001). The post-hoc analysis showed that after training the participants in Group 4 had more correct responses than the respondents in Group 3, 2, 1 i.e. Δ = 5.2, Δ = 1.5, Δ = 0.3, respectively. The respondents from Group 3 gave the lowest number of correct responses in other groups. Conclusions: The most effective method of informing people about the primary prevention of hypertension using a social media website corresponded to the following sequence: a video clip followed by a text post.
ABSTRACT
We studied association of PCSK9 protein with the carotid artery intima-media thickness in patients with familial hypercholesterolemia (N=53; age 49.9±6.9 years) treated with statins. Blood level of PCSK9 protein was measured by ELISA; ultrasonography of the carotid arteries with measurement of the thickness of the intima-media complex of the common carotid arteries in the distal segment for 10 mm from the bifurcation on the far wall of the vessel was performed in on-line mode. The mean values were calculated for both sides, the maximum mean value was included in the analysis. It was shown that PCSK9 levels positively correlate with carotid artery intima-media thickness in patients with familial hypercholesterolemia.
