Key result
Automated EHR alerts increase new MRA prescribing ~153% vs usual care in HFrEF patients.
Why the study?
Does an automated EHR-embedded alert or message improve new MRA prescribing in adult patients with HFrEF?
RCT (n=2,211)
Cluster-randomized
Yes
Does an automated EHR-embedded alert or message improve new MRA prescribing in adult patients with HFrEF?
Relative Risk: 2.53 (95% CI 1.77–3.62)
Absolute Event Rate: 29.6% vs 11.7%
Number Needed to Treat: 5.6
p-value: p=<0.0001
An automated, patient-specific EHR alert significantly increased MRA prescribing for eligible HFrEF patients compared to usual care or bulk messaging.
No takes yet. Share an insight, caveat, or question.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This is a really important study, because despite overwhelming evidence for more than a decade favoring MRA use for patients with HFrEF there is an incredibly large treatment gap. MRAs can reduce all-cause death in people with HFrEF by 25%-30%, as well as reduce hospitalizations for heart failure, at a cost of less than $50 a year.”
“EHR tools can be a rapid, low-cost and high-impact method to increase prescription of lifesaving therapies across large populations.”
“absolutely critical”
EHR alerts warrant routine integration for eligible HFrEF patients; extends implementation evidence for closing persistent MRA treatment gaps.
Mukhopadhyay et al. (2023) conducted an RCT in Heart failure with reduced ejection fraction (HFrEF) (n=2,211). Automated EHR-embedded alert during individual patient encounters vs. Usual care and message about multiple patients between encounters was evaluated on New MRA prescribing (RR 2.53, 95% CI 1.77-3.62, p=<0.0001). An automated EHR-embedded alert during patient encounters significantly increased new MRA prescribing compared to usual care (29.6% vs 11.7%; RR 2.53; 95% CI 1.77-3.62; P<0.0001) in HFrEF patients.