Correction to: Effect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health Care: The Treatment of Cardiovascular Risk Using Electronic Decision Support Cluster-Randomized Trial.

Abstract

HomeCirculation: Cardiovascular Quality and OutcomesVol. 11, No. 9Correction to: Effect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health Care: The Treatment of Cardiovascular Risk Using Electronic Decision Support Cluster-Randomized Trial Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection to: Effect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health Care: The Treatment of Cardiovascular Risk Using Electronic Decision Support Cluster-Randomized Trial Originally published5 Sep 2018https://doi.org/10.1161/HCQ.0000000000000049Circulation: Cardiovascular Quality and Outcomes. 2018;11:e000049This article corrects the followingEffect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health CareIn the article by Peiris et al, “Effect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health Care: The Treatment of Cardiovascular Risk Using Electronic Decision Support Cluster-Randomized Trial,” which appeared in the January 2015 issue of the journal (Circulation: Cardiovascular Quality and Outcomes.2015;8:87–95. doi: 10.1161/CIRCOUTCOMES.114.001235), several corrections were needed.The authors discovered an error in the statistical analyses relating to the calculation of prescribing rates for baseline data. There was a statistical coding error in analyzing baseline medication prescribing data at 4 health service sites (3 intervention and 1 control site). This resulted in people at high CVD risk at these 4 sites (more in intervention than in control) being incorrectly considered as not being prescribed recommended medicines at baseline.The authors have corrected the error in their analyses, which has resulted in the following changes to the article:– The baseline recommended prescribing rates are now more balanced in both arms (Table 2).– The primary outcomes are unchanged as they were based on end of study data.– The magnitude and strength of the escalation in treatment secondary outcomes was affected.– The blood pressure and antiplatelet intensification outcomes remain significant, but the lipid intensification secondary outcome is no longer significant (Figure 2).– For the post-hoc analysis of the under-treated high risk group at baseline, there is no longer heterogeneity with the total high risk population, although the effect of the intervention remains significant for this subgroup.The following changes have been made to the text.In the Abstract, “There were significant treatment escalations (new prescriptions or increased numbers of medicines) for antiplatelet (17.9% versus 2.7%; P<0.001), lipid-lowering (19.2% versus 4.8%; P<0.001), and blood pressure–lowering medications (23.3% versus 12.1%; P=0.02)” should read “There were significant treatment escalations (new prescriptions or increased numbers of medicines) for antiplatelet (4.3% versus 2.7%; P=0.01), and BP lowering (18.2% versus 11.0%; P=0.02) but not lipid-lowering medications”.In the Results, “For the high-risk cohort (n=10 308), baseline prescription rates of recommended medications were 46.7% (intervention) and 52.8% (control; Table 2)” should read “For the high-risk cohort (n=10 308), baseline prescription rates of recommended medications were 58.1% (intervention) and 55.7% (control; Table 2)”.“The intervention was most strongly associated with escalation of medications for patients at high risk (new prescriptions or increased numbers of medications) with respect to antiplatelet medications (17.9% versus 2.7%; RR, 4.80; 95% CI, 2.47–9.29; P<0.001), lipid-lowering medications (19.2% versus 4.8%; RR, 3.22; 95% CI, 1.77–5.88; P<0.001), and BP-lowering medications (23.3% versus 12.1%; RR, 1.89; 95% CI, 1.08–3.28; P=0.02)” should read “The intervention was most strongly associated with escalation of medications for patients at high risk (new prescriptions or increased numbers of medications) with respect to antiplatelet medications (4.3% versus 2.7%; RR, 1.67; 95% CI, 1.13–2.48; P=0.01), and BP lowering medications (18.2% versus 11.0%; RR, 1.64; 95% CI, 1.07–2.52; P=0.02) but not lipid-lowering medications (6.1% versus 4.7%; RR, 1.30; 95% CI, 0.95–1.78; P=0.30)”.“In a post hoc analysis, there was a significant heterogeneity of effect according to whether patients were prescribed recommended medicines at baseline (interaction P=0.03) with those not prescribed medicines (n=5090) showing a large improvement (38.3% versus 20.9%; RR, 1.59; 95% CI, 1.19–2.13; P<0.001)” should read “In a post hoc analysis, patients who were not prescribed recommended medicines at baseline (n=4336) showed significant improvements in recommended prescribing (23.2% versus 18.3%; RR, 1.33; 95% CI, 1.06–1.67; P=0.02)”.In Table 2, the data in the row headed “Patients at high CVD risk with appropriate medical management” should be corrected. In the “Intervention” column, the data for n (%) should read “3134 (58.1%)”. In the “Usual Care” column, the data for n (%) should read “2737 (55.7%)”. The data in the P value column should read “0.19”.Lastly, a corrected version of Figure 2 has been provided.These corrections have been made to the article, which is available at https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.114.001235Footnoteshttps://www.ahajournals.org/journal/circoutcomes Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesEffect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health CareDavid Peiris, et al. Circulation: Cardiovascular Quality and Outcomes. 2015;8:87-95 September 2018Vol 11, Issue 9 Advertisement Article InformationMetrics © 2018 American Heart Association, Inc.https://doi.org/10.1161/HCQ.0000000000000049PMID: 30354554 Originally publishedSeptember 5, 2018 PDF download Advertisement