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The purpose of the study is to examine the impact of augmented, high-quality physician-coordinated care executed via an electronic health record (EHR)-based intervention on quality of care for gastroesophageal reflux disease (GERD) and for gastroprotection for patients on chronic non-steroidal anti-inflammatory drugs (NSAIDs) at increased risk for upper GI tract ulcers and ulcer related complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | GERD: Patients with established diagnoses of GERD based on ICD-9 codes | ||
| 2 | Atypical GERD: Patients without an established diagnosis of GERD with atypical symptoms that could be due to GERD (e.g., asthma) | ||
| 3 | Chronic NSAID users: Patients using chronic NSAIDs who are at increased risk of GI complications (defined as previous diagnosis of peptic ulcer disease; age 75 or older; or concomitant use of corticosteroids, anticoagulants, or aspirin) |
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| Measure | Description | Time Frame |
|---|---|---|
| Diagnoses of GERD | After 12 months of intervention | |
| Prescriptions for gastroprotective medicines in at-risk, chronic NSAID users | After 12 months of intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Prescriptions for GERD medications | After 12 months of intervention | |
| Change in GERD symptoms score | After 12 months of intervention | |
| NSAID-related GI complications |
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Inclusion Criteria:
Exclusion Criteria:
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Primarily primary care practices of physicians participating in the Medical Quality Improvement Consortium (MQIC)
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| Name | Affiliation | Role |
|---|---|---|
| James M Gill, MD, PhD | Delaware Valley Outcomes Research | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21242557 | Result | Gill JM, Mainous AG 3rd, Koopman RJ, Player MS, Everett CJ, Chen YX, Diamond JJ, Lieberman MI. Impact of EHR-based clinical decision support on adherence to guidelines for patients on NSAIDs: a randomized controlled trial. Ann Fam Med. 2011 Jan-Feb;9(1):22-30. doi: 10.1370/afm.1172. |
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| ID | Term |
|---|---|
| D005764 | Gastroesophageal Reflux |
| D010437 | Peptic Ulcer |
| ID | Term |
|---|---|
| D015154 | Esophageal Motility Disorders |
| D003680 | Deglutition Disorders |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
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| After 12 months of intervention |
| D004066 | Digestive System Diseases |
| D004378 | Duodenal Diseases |
| D007410 | Intestinal Diseases |
| D013272 | Stomach Diseases |