JMIR Publications

ABSTRACT

Background:

In addition to aspirin, angiotensin converting enzyme-inhibitors (ACE-I) and statins and lifestyle modification interventions, novel pharmacological agents have been shown to reduce morbidity and mortality in atherosclerotic cardiovascular disease (ASCVD) patients, including new antithrombotics, antihyperglycemics and lipid-modulating therapies. Despite their benefit, uptake of these guidelines-directed therapies remains a challenge. There is a need to develop strategies to support knowledge translation for uptake of secondary prevention therapies.

Objective:

The goal of this study was to test the feasibility and usability of STOP-CVD, a point-of-care application that designed to knowledge translation by providing individualized risk stratification and optimization guidance.

Methods:

Using the REACH registry trial and predictive modeling (which included 49,689 patients), we designed a free web-based secondary risk calculator. Based on demographic and comorbidity profiles, the application was used to predict an individual’s 20-month risk of CV events and CV mortality and provides comparison to an age-matched control with optimized CV risk profile to illustrate the modifiable residual risk. Additionally, the application utilized the patient’s risk profile to provide specific guidance for possible therapeutic interventions based on a novel algorithm. During an initial 3-month adoption phase, one-time invitations were sent via email and/or telephone to 240 physicians that refer to a regional cardiovascular clinic. After 3-months, a survey of user experience was sent to all users. Following this, no further marketing of the application was performed. Google Analytics were collected post-implementation from January 2021 to December 2021. These were used to tabulate the total number of distinct users and the total number of monthly uses of the application.

Results:

During the 1-year pilot, 47 of the 240 invited clinicians used the application 1,573 times, an average of 131 times per month, with sustained usage over time. All 24 post-implementation survey respondents confirmed that the application was functional, easy to use, useful.

Conclusions:

This pilot confirms that the STOP-CVD application is feasible and usable with high clinician satisfaction. This tool can be easily scaled to support uptake of guideline-directed medical therapy, which could improve clinical outcomes. Future research will be focused on evaluating the impact of this tool on clinician management and patient outcomes.