Intervention
stroke, bleeding, AF
STROKE, BLEEDING
The CDS in the IMPACT-AF trial was a web-based software tool designed to support the management of AF patients in primary care. It offered best practice recommendations in regard to diagnostic assessment and treatment, per Canadian AF clinical guidelines, allowed surveillance of AF patients through a range of data sources (electronic laboratory results and patient-reported data), and prompted primary care providers to respond to critical alerts and trends. The system also had web-based education and support for providers and patients. Specific features of the CDS included:
Translation of best-evidence to primary care providers (PCPs) through computerization of Canadian AF clinical guidelines;Enabling specific tasks such as auto-calculation of stroke and bleeding risk scores, monitoring of international normalized ratio (INR) and creatinine clearance with subsequent recommendations for medication dosing adjustment, assisting with optimal warfarin management via a dosing calculator, and providing recommendations for initiation and switching OACs based on patient clinical characteristics and ability to pay for medications;Providing a non-vitamin-K antagonist (NOAC) special authorization tool that aligns with the Nova Scotia Seniors Pharmacare exception status criteria and automatically prepopulates a drug coverage application form.Additional information on the CDS is reported elsewhere [