The impact of a clinical decision support service on adherence to clinical guidelines and achieving target low-density lipoprotein cholesterol levels in patients at risk of cardiovascular events in the Kemerovo Oblast (SuccESS Study in the Kemerovo Oblast)

Aim. To evaluate the effectiveness of an analytical service with a clinical decision support system (CDSS) in increasing the frequency of monitoring low-density lipoprotein cholesterol (LDL-C) levels in patients with acute cardiovascular events (CVE), coronary artery disease (CAD), or dyslipidemia in the Kemerovo Oblast.Material and methods. This non-interventional retrospective multicenter study was conducted in 16 health facilities of the Kemerovo Oblast from January 1, 2022 to March 31, 2024. There were main cohort (6694 patients with CVE) and an additional cohort (12174 patients with CAD or dyslipidemia). The study included two following follow-up periods: before (12 months) and after (15 months) the CDSS implementation. The CDSS was implemented through integration into the regional health information system (HIS). Physicians at the automated workplace in the single-window mode in the HIS received recommendations for the examination and treatment of patients according to clinical guidelines and Order 168n, as well as access to an analytical platform for monitoring patients with suboptimal indicators (including LDL-C ³1,4 mmol/L or no data on LDL-C at very high cardiovascular risk). The primary endpoint was the proportion of patients with a single determination of LDL-C levels within 6 and 12 months after the index event.Results. In the main cohort, the proportion of patients with LDL-C assessment increased from 11,1% to 14,8% (relative change +33%, p