CDSSs for CVD Risk Management: An Integrative Review

Cardiovascular disease (CVD) is a preventable disease affecting almost half of adults in the United States (U.S.) and can have significant negative outcomes such as stroke and myocardial infarction, which can be fatal. Utilizing clinical decision support systems (CDSSs) in the primary care and community health setting can improve primary prevention of CVD by supporting evidence-based decision making at the point of care. This integrative review synthesizes the most up-to-date literature on the use of clinical decision support (CDS) tools to support guideline-based management of CVD risk. Using Whittemore and Knafl’s framework for integrative reviews, a systematic search of CINAHL, Cochrane, and Medline and ancestry search yielded 492 results; 17 articles were included in the final review after applying inclusion and exclusion criteria. Evidence-based CDSSs for CVD prevention improved guideline-based initiation and intensification of pharmacological treatment, increased frequency and accuracy of CVD risk screening, and facilitated shared decision-making discussions with patients about CVD risk; however, they were not effective in promoting smoking cessation and only sometimes effective in improving blood pressure (BP) control. This integrative review supports future evidence-based practice projects implementing CDSSs designed to improve guideline-based primary prevention of CVD as an, albeit partial, solution to improving prevention of CVD in the U.S. and globally