EHR Nudges for Statin Prescribing: Not There Yet

Electronic health record-based clinical decision support (EHR CDS) alerts didn’t increase statin prescribing in a three-arm cluster-randomized trial.
Statin prescribing at guideline-recommended doses increased from 41.2% to 44.5% among cardiologists randomized to 6 months of pop-up alerts requiring action, but that was no better than the slight bump seen among controls receiving no intervention (from 41.8% to 42.6%, P=0.08 between groups).
However, for the subgroup of patients with clinical atherosclerotic cardiovascular disease (ASCVD), the active choice intervention did lead to significantly improved statin prescribing at the optimal dose (from 39.8% to 44.6%, P=0.008), reported Mitesh Patel, MD, MBA, of the University of Pennsylvania in Philadelphia, and colleagues.
Whether there is really a benefit for this subgroup of patients warrants further study, Patel’s group wrote in a manuscript published online in JAMA Cardiology.
The active choice intervention consisted of an unchanging pop-up alert in the EHR that required