title: [Computer-assisted cardiovascular disease management: better implementation of care but no improvement in clinical outcomes].
abstract: Computer support is considered by many to be a promising strategy for improving healthcare interventions, especially in the management of chronic diseases. So far, however, evidence of the effectiveness of ICT support in healthcare is limited. Recently, computer-supported cardiovascular disease management was compared with usual care during an RCT comprised of 1100 primary care patients. This trial demonstrated that neither the clinical outcome nor the cardiovascular morbidity rate improved, even though management of the risk factors improved over 1 year of follow-up. The pragmatic design of the RCT in daily general practice may have restricted implementing the computer support, and may also have hampered the evaluation of the cardiovascular effects. The results demonstrate that although computer support may help improve the performance of disease management, its impact on disease outcomes is questionable. ICT innovations in healthcare require rigorous investigative evaluation before their implementation in daily practice can be justified.
authors.affiliation: Universitair Medisch Centrum Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns geneeskunde, afd. Huisartsgeneeskunde, Utrecht, the Netherlands. N.J.dewit@umcutrecht.nl
authors.forename: Niek J
authors.initials: NJ
authors.lastname: de Wit
mesh_terms: D002318:Cardiovascular Diseases / Q000628:therapy*; D003201:Computers / Q000706:statistics & numerical data*; D019468:Disease Management; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome