Piloting a multifaceted, electronic medical record– based intervention to improve prescription of anticoagulation (SUPPORT AF)

Kapoor et al (J Am Heart Assoc 2018;7:e009946, PMID 30371161) conducted a prospective quality improvement initiative to assess whether use of an electronic medical record–based intervention could improve use of oral anticoagulation for the prevention of atrial fibrillation–related stroke. The intervention had 2 parts. First, providers were informed of their oral anticoagulation-prescribing patterns relative to their peers. Second, electronic medical record messages were sent the day before they saw a patient with atrial fibrillation who was eligible for, but not receiving, oral anticoagulation. After 10 weeks, among the 227 providers, there was no change in oral anticoagulation utilization in either the cardiology (0.2% lower) or primary care (0.01% higher) providers relative to controls. Based on these data, the authors conclude that the use of an electronic medical record–based intervention is feasible but, by itself, did not improve utilization of oral anticoagulation in their practice environment.