Response | Measure | Question | Pre-implementation | p-value | Post-implementation | p-value | Treatment by time interaction p-value | ||
---|---|---|---|---|---|---|---|---|---|
CDS | UC | CDS | UC | ||||||
n =Â 102 | n =Â 60 | n =Â 78 | n =Â 53 | ||||||
 |  | Please mark the response that best fits your experience in providing care to adult patients who are at high risk of cardiovascular disease or diabetes |  |  |  |  |  |  |  |
0–10 | Always | At typical clinic visits for non-acute illnesses, how often do you discuss CV risk reduction with your patients? n (% Always) | 74 (72.5) | 50 (83.3) | 0.1177 | 53 (70.7) | 39 (75.0) | 0.5910 | 0.2449 |
0–10 | Always | At these typical clinic visits, how well prepared do you feel to prioritize CV risk factors and discuss them with your patients? n (% Always) | 79 (78.2) | 47 (78.3) | 0.9863 | 60 (80.0) | 42 (82.4) | 0.7413 | 0.3152 |
0–10 | Always | At these typical clinic visits, how often do you use CV risk calculations while seeing patients? n (% Always) | 46 (45.1) | 17 (28.3) | 0.0345 | 39 (52.0) | 23 (45.1) | 0.4469 | 0.3990 |
 |  | When you use a CV risk calculator for patient care, which source do you use most often? |  |  | 0.3465 |  |  | 0.9029 |  |
 |  | Use a smartphone-based calculator (i.e., an App), n (%) | 18 (17.6) | 11 (18.3) |  | 9 (11.8) | 7 (13.5) |  |  |
 |  | Use a link within the Epic EMR to a CV risk calculator, n (%) | 61 (59.8) | 30 (50.0) |  | 52 (68.4) | 33 (63.5) |  |  |
 |  | Use a web-based calculator (not linked through the Epic EMR), n (%) | 6 (5.9) | 8 (13.3) |  | 8 (10.5) | 4 (7.7) |  |  |
0–10 | Always | At typical clinic visits for non-acute illnesses, how often do you discuss prevention of diabetes with your patients? n (% Always) | 61 (60.4) | 42 (70.0) | 0.2197 | 43 (57.3) | 33 (63.5) | 0.4885 | 0.6865 |
0–100% |  | What percentage of the time, from 0% to 100%, do you feel patients initiate conversations with you about risk factors for developing diabetes or heart disease? (95% Cl) | (23.6, 31.4) | (21.2, 31.1) | 0.6707 | (24.1, 33.0) | (18.9, 30.4) | 0.2748 | 0.6539 |
0–10 | Easy | At these typical clinical visits, how easy is it to follow aspirin guidelines to determine if a patient will benefit from taking aspirin for primary prevention (e.g., US Preventive Services Task Force recommendations)? n (% Easy) | 45 (44.6) | 28 (47.5) | 0.7221 | 29 (38.2) | 27 (51.9) | 0.1231 | 0.7072 |
0–10 | Well prepared | At typical clinic visits for patients with prediabetes, how well prepared do you feel to discuss metformin or other glucose-lowering medications for preventing diabetes or reducing CV risk? n (% Well prepared) | 67 (65.7) | 43 (71.7) | 0.4311 | 64 (84.2) | 40 (80.0) | 0.5425 | 0.4500 |
0–10 | Well prepared | At typical clinic visits for patients with prediabetes, how well prepared do you feel to discuss dietary and physical activity recommendations for preventing diabetes or reducing CV Risk? n (% Well prepared) | 96 (95.0) | 52 (88.1) | 0.1092 | 74 (97.4) | 45 (90.0) | 0.0773 | 0.6382 |
0–10 | Important | How important do you feel it is to screen adult patients at risk for prediabetes? n (% Important) | 93 (91.2) | 56 (93.3) | 0.6256 | 72 (94.7) | 46 (92.0) | 0.5377 | 0.8049 |
0–10 | Important | If a patient is in the prediabetes blood glucose range, how important is it to provide a diagnosis of prediabetes (i.e., add to the problem list and/or use ICD-10 diagnostic code)? n (% Important) | 79 (78.2) | 52 (86.7) | 0.1831 | 65 (85.5) | 42 (84.0) | 0.8148 | 0.5471 |
0–10 | Important | How important do you feel it is to talk to patients with prediabetes who are less than 65 years of age about use of metformin or other glucose-lowering medications? n (% Important) | 62 (60.8) | 43 (71.7) | 0.1613 | 55 (73.3) | 32 (64.0) | 0.2664 | 0.4503 |