Ignite Creation Date:
2024-05-06 @ 7:27 PM
Last Modification Date:
2024-10-26 @ 3:07 PM
Study NCT ID:
NCT06014268
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2023-08-28
First Post:
2023-08-23
Brief Title:
Electronic Clinical Decision Support System eCDSS for Prevention of Atrial Fibrillation-related Stroke
Sponsor:
South London and Maudsley NHS Foundation Trust
Organization:
South London and Maudsley NHS Foundation Trust
Study Overview
Official Title:
Implementation of an Electronic Clinical Decision Support System eCDSS for Prevention of Atrial Fibrillation-related Stroke in a Mental Healthcare Setting a Feasibility Study
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2023-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
eCDSS
Brief Summary:
Cardiovascular diseases are the leading cause of premature mortality in people with serious mental illness such as schizophrenia bipolar disorder schizoaffective disorder and dementia Atrial fibrillation AF is the most prevalent cardiac arrhythmia and is associated with fivefold increased risk of stroke also contributing to heart failure and death
Electronic clinical decision support systems eCDSS are computer based programs that analyse data within electronic health records EHRs and provide prompts to assist health care providers in implementing evidencebased clinical guidelines Adoption of an eCDSS to address the risk of stroke in people with AF and co-morbid mental illness presents a unique opportunity for research but requires evidence of acceptability and feasibility
This study aims to establish the feasibility and acceptability of an eCDSS CogstackMaudsley for AF-related stroke prevention in Mental Health of Older Adults inpatient wards
First we will conduct surveys and interviews with clinicians on inpatient wards to scope experiences of managing atrial fibrillation in secondary mental healthcare settings and attitudes towards use of digital technologies to aid in clinical decision making A feasibility study will then be run to evaluate the acceptability and feasibility of implementing eCDSS on inpatient wards Finally participating clinicians will be invited to take part in a survey and interview which will explore their experiences and attitudes towards using the eCDSS
Electronic clinical decision support systems eCDSS are computer based programs that analyse data within electronic health records EHRs and provide prompts to assist health care providers in implementing evidencebased clinical guidelines Adoption of an eCDSS to address the risk of stroke in people with AF and co-morbid mental illness presents a unique opportunity for research but requires evidence of acceptability and feasibility
This study aims to establish the feasibility and acceptability of an eCDSS CogstackMaudsley for AF-related stroke prevention in Mental Health of Older Adults inpatient wards
First we will conduct surveys and interviews with clinicians on inpatient wards to scope experiences of managing atrial fibrillation in secondary mental healthcare settings and attitudes towards use of digital technologies to aid in clinical decision making A feasibility study will then be run to evaluate the acceptability and feasibility of implementing eCDSS on inpatient wards Finally participating clinicians will be invited to take part in a survey and interview which will explore their experiences and attitudes towards using the eCDSS
Detailed Description:
Cardiovascular diseases are the leading cause of premature mortality in people with serious mental illness SMI such as schizophrenia bipolar disorder and schizoaffective disorder and dementia Atrial fibrillation AF is the most prevalent cardiac arrhythmia and is associated with fivefold increased risk of stroke also contributing to heart failure and death
According to the National Institute for Health and Care Excellence NICE guidelines the management of AF requires a comprehensive assessment of risk factors for thromboembolic using the CHAD2AD2-VASc tool and bleeding events using ORBIT or HAS-BLED tools and long-term treatment with oral anticoagulants OAC when appropriate
Although oral anticoagulation has been effective in reducing the risk of stroke in people with AF underuse continues to be reported especially in patients with co-morbid SMI andor dementia
The primary objective of this study is to establish the feasibility and acceptability of an eCDSS compromising a real-time computerised alerting and clinical decision support system for AF-related stroke prevention in secondary mental healthcare We will conduct a process evaluation to assess the barriers facilitators and unintended consequences of implementing the system onto an inpatient mental health of older adult ward Data gathered from this study will allow us to refine the system address potential problems with future successful implementation and inform larger trials
This feasibility study will be conducted over a period of 3 months in Mental Health of Older Adults inpatient wards at South London and Maudsley NHS Foundation Trust
Wards participating in the study will receive the electronic clinical decision support system eCDSS with clinicians being the end-users
The key digital tool to be used for eCDSS in this study is CogStack which is an open source information retrieval and extraction system with the capability to offer near real-time natural language processing NLP of electronic health records The eCDSS will alert clinicians if patients with documented atrial fibrillation are admitted to the hospital under their care Alerts will be triggered by the presence of old or new diagnosis of atrial fibrillation AF on the electronic health records
The eCDSS will consist of prompts appearing on patients electronic health records asking clinicians to clinically assess the risk of stroke using CHAD2AD2-VASc tool and the risk of bleeding using the ORBIT tool and record the scores in clinical notes
According to the National Institute for Health and Care Excellence NICE guidelines the management of AF requires a comprehensive assessment of risk factors for thromboembolic using the CHAD2AD2-VASc tool and bleeding events using ORBIT or HAS-BLED tools and long-term treatment with oral anticoagulants OAC when appropriate
Although oral anticoagulation has been effective in reducing the risk of stroke in people with AF underuse continues to be reported especially in patients with co-morbid SMI andor dementia
The primary objective of this study is to establish the feasibility and acceptability of an eCDSS compromising a real-time computerised alerting and clinical decision support system for AF-related stroke prevention in secondary mental healthcare We will conduct a process evaluation to assess the barriers facilitators and unintended consequences of implementing the system onto an inpatient mental health of older adult ward Data gathered from this study will allow us to refine the system address potential problems with future successful implementation and inform larger trials
This feasibility study will be conducted over a period of 3 months in Mental Health of Older Adults inpatient wards at South London and Maudsley NHS Foundation Trust
Wards participating in the study will receive the electronic clinical decision support system eCDSS with clinicians being the end-users
The key digital tool to be used for eCDSS in this study is CogStack which is an open source information retrieval and extraction system with the capability to offer near real-time natural language processing NLP of electronic health records The eCDSS will alert clinicians if patients with documented atrial fibrillation are admitted to the hospital under their care Alerts will be triggered by the presence of old or new diagnosis of atrial fibrillation AF on the electronic health records
The eCDSS will consist of prompts appearing on patients electronic health records asking clinicians to clinically assess the risk of stroke using CHAD2AD2-VASc tool and the risk of bleeding using the ORBIT tool and record the scores in clinical notes
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None