ADH-Wizard
Trial question
What is the effect of clinical decision support in managing cardiometabolic medication adherence?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
45.0% female
55.0% male
N = 5421
5421 patients (2431 female, 2990 male).
Inclusion criteria: adult patients undergoing treatment for hypertension, diabetes, and dyslipidemia.
Key exclusion criteria: pregnancy; those living in long-term care facilities; receipt of parenteral cancer chemotherapy; hospice care.
Interventions
N=2745 clinical decision support (electronic health record-linked enhanced clinical decision support with medication adherence alerts to patients and providers).
N=2676 usual care (receipt of basic cardiovascular-related clinical decision support without medication adherence information).
Primary outcome
Adherence to glucose control medications at 12 months
47.1%
46.8%
47.1 %
35.3 %
23.6 %
11.8 %
0.0 %
Clinical decision
support
Usual
care
No significant
difference ↔
No significant difference in adherence to glucose control medications at 12 months (47.1% vs. 46.8%; OR 1.03, 95% CI 0.82 to 1.3).
Secondary outcomes
Significant decrease in adherence to BP control medications at 12 months (53% vs. 47%; OR 0.77, 95% CI 0.64 to 0.94).
No significant difference in adherence to statins at 12 months (55.1% vs. 50.9%; OR 1.18, 95% CI 0.99 to 1.41).
Significantly lower reduction in HbA1c at 12 months (1.2% vs. 1.1%; beta 0.2, 95% CI -0.1 to 0.4).
Conclusion
In adult patients undergoing treatment for hypertension, diabetes, and dyslipidemia, clinical decision support was not superior to usual care with respect to adherence to glucose control medications at 12 months.
Reference
Patrick J O'Connor, Jacob L Haapala, Steven P Dehmer et al. Clinical Decision Support and Cardiometabolic Medication Adherence: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jan 2;8(1):e2453745.
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