| Autor: |
Ju-Yeh Yang, Kai-Hsiang Shu, Yu-Sen Peng, Shih-Ping Hsu, Yen-Ling Chiu, Mei-Fen Pai, Hon-Yen Wu, Wan-Chuan Tsai, Kuei-Ting Tung, Raymond N Kuo |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
JMIR Formative Research, Vol 7, p e44373 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2561-326X |
| DOI: |
10.2196/44373 |
| Popis: |
BackgroundPrevious studies on clinical decision support systems (CDSSs) for the management of renal anemia in patients with end-stage kidney disease undergoing hemodialysis have previously focused solely on the effects of the CDSS. However, the role of physician compliance in the efficacy of the CDSS remains ill-defined. ObjectiveWe aimed to investigate whether physician compliance was an intermediate variable between the CDSS and the management outcomes of renal anemia. MethodsWe extracted the electronic health records of patients with end-stage kidney disease on hemodialysis at the Far Eastern Memorial Hospital Hemodialysis Center (FEMHHC) from 2016 to 2020. FEMHHC implemented a rule-based CDSS for the management of renal anemia in 2019. We compared the clinical outcomes of renal anemia between the pre- and post-CDSS periods using random intercept models. Hemoglobin levels of 10 to 12 g/dL were defined as the on-target range. Physician compliance was defined as the concordance of adjustments of the erythropoietin-stimulating agent (ESA) between the CDSS recommendations and the actual physician prescriptions. ResultsWe included 717 eligible patients on hemodialysis (mean age 62.9, SD 11.6 years; male n=430, 59.9%) with a total of 36,091 hemoglobin measurements (average hemoglobin and on-target rate were 11.1, SD 1.4, g/dL and 59.9%, respectively). The on-target rate decreased from 61.3% (pre-CDSS) to 56.2% (post-CDSS) owing to a high hemoglobin percentage of >12 g/dL (pre: 21.5%; post: 29%). The failure rate (hemoglobin |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
