Effect of health information technology interventions on lipid management in clinical practice: A systematic review of randomized controlled trials
Abstract
Background Large gaps in lipid treatment and medication adherence persist in high-risk outpatients in the United States. Health information technology (HIT) is being applied to close quality gaps in chronic illness care, but its utility for lipid management has not been widely studied.Objective To perform a qualitative review of the impact of HIT interventions on lipid management processes of care (screening or testing; drug initiation, titration or adherence; or referrals) or clinical outcomes (percent at low density lipoprotein cholesterol goal; absolute lipid levels; absolute risk scores; or cardiac hospitalizations) in outpatients with coronary heart disease or at increased risk.Methods PubMed and Google Scholar databases were searched using Medical Subject Headings related to clinical informatics and cholesterol or lipid management. English language articles that described a randomized controlled design, tested at least one HIT tool in high risk outpatients, and reported at least 1 lipid management process measure or clinical outcome, were included.Results Thirty-four studies that enrolled 87,874 persons were identified. Study ratings, outcomes, and magnitude of effects varied widely. Twenty-three trials reported a significant positive effect from a HIT tool on lipid management, but only 14 showed evidence that HIT interventions improve clinical outcomes. There was mixed evidence that provider-level computerized decision support improves outcomes. There was more evidence in support of patient-level tools that provide connectivity to the healthcare system, as well as system-level interventions that involve database monitoring and outreach by centralized care teams.Conclusion Randomized controlled trials show wide variability in the effects of HIT on lipid management outcomes. Evidence suggests that multilevel HIT approaches that target not only providers but include patients and systems approaches will be needed to improve lipid treatment, adherence and quality.
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A review of randomized trials at system, practitioner, and patient levels for lipid management using health information technology found better management in system-level and individual-patient implementations.
“A recent review of system, practitioner, and individual patient-level randomized trials to evaluate level-specific lipid management approaches that all used a health information technology component concluded that systems and individual patient implementations showed better management (4).”
From An Overview of Research and Evaluation Designs for Dissemination and Implementation (2017) · cites this paper as [4]
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- Authors
- Aspry, K. E., Furman, R., Karalis, D. G., Jacobson, T. A., Zhang, A. M., Liptak, G. S., & Cohen, J. D.
- Affiliations
- Brown University (US)
- Pennsylvania Hospital (US)
- Emory University (US)
- Saint Louis University (US)
- Corresponding author
- Aspry, Karen E.
- Venue
- Journal of Clinical Lipidology
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 7
- Issue
- 6
- Pages
- 546-560
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- OpenAlex
- W2082139119
- Cited by
- 41
- References
- 78
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 7 · 2022: 6 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 4
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of clinical lipidology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- health information technology, lipid control, cholesterol screening, LDL cholesterol goal attainment, medication adherence, decision support system, multilevel interventions, coronary artery disease, cardiovascular risk, quality of care gaps
- MeSH terms
- Humans, Lipids, Cholesterol, LDL, Medical Informatics, Randomized Controlled Trials as Topic, Databases, Factual
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