Capsule commentary on Persell et.al.; Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: A cluster randomized trial

摘要

This trial by Persell et al.1 tested an intervention that leveraged electronic health records to identify patients with risk factors for cardiovascular disease but not receiving statin treatment. The investigators provided a list of patients meeting these criteria to clinicians and mailed personalized letters to the patients on the list, offering advice regarding the benefit of statin treatment, controlling hypertension or quitting smoking. The result was not more contacts with primary care clinicians, but more productive contacts with respect to cardiovascular risk reduction. In particular, a greater proportion of intervention patients received statin prescriptions, with a nonsignificant trend towards greater hypertensive treatment. While there was no difference in low-density lipoprotein (LDL) levels at 9 months, a post-hoc analysis at 18 months showed benefit.