{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T01:06:41Z","timestamp":1769562401070,"version":"3.49.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["K12HL137862"],"award-info":[{"award-number":["K12HL137862"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["1K23HL161352"],"award-info":[{"award-number":["1K23HL161352"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare the effectiveness of 2 clinical decision support (CDS) tools to avoid prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with heart failure (HF): a \u201ccommercial\u201d and a locally \u201ccustomized\u201d alert.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study of 2 CDS tools implemented within a large integrated health system. The commercial CDS tool was designed according to third-party drug content and EHR vendor specifications. The customized CDS tool underwent a user-centered design process informed by implementation science principles, with input from a cross disciplinary team. The customized CDS tool replaced the commercial CDS tool. Data were collected from the electronic health record via analytic reports and manual chart review. The primary outcome was effectiveness, defined as whether the clinician changed their behavior and did not prescribe an NSAID.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A random sample of 366 alerts (183 per CDS tool) was evaluated that represented 355 unique patients. The commercial CDS tool was effective for 7 of 172 (4%) patients, while the customized CDS tool was effective for 81 of 183 (44%) patients. After adjusting for age, chronic kidney disease, ejection fraction, NYHA class, concurrent prescription of an opioid or acetaminophen, visit type (inpatient or outpatient), and clinician specialty, the customized alerts were at 24.3 times greater odds of effectiveness compared to the commercial alerts (OR: 24.3 CI: 10.20\u201358.06).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Investing additional resources to customize a CDS tool resulted in a CDS tool that was more effective at reducing the total number of NSAID orders placed for patients with HF compared to a commercially available CDS tool.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocad109","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T22:52:18Z","timestamp":1687647138000},"page":"1516-1525","source":"Crossref","is-referenced-by-count":5,"title":["Comparative effectiveness of generic commercial versus locally customized clinical decision support tools to reduce prescription of nonsteroidal anti-inflammatory drugs for patients with heart failure"],"prefix":"10.1093","volume":"30","author":[{"given":"Courtney","family":"Shakowski","sequence":"first","affiliation":[{"name":"UCHealth , Aurora, Colorado, USA"}]},{"given":"Robert L","family":"Page II","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Garth","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Cali","family":"Lunowa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Clyde","family":"Marquez","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Krithika","family":"Suresh","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Outcomes Research and Delivery Science Center , Aurora, Colorado, USA"},{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health , Aurora, Colorado, USA"}]},{"given":"Larry A","family":"Allen","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Outcomes Research and Delivery Science Center , Aurora, Colorado, USA"},{"name":"Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Russel E","family":"Glasgow","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Outcomes Research and Delivery Science Center , Aurora, Colorado, USA"},{"name":"Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Chen-Tan","family":"Lin","sequence":"additional","affiliation":[{"name":"UCHealth , Aurora, Colorado, USA"},{"name":"Division of Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]},{"given":"Abraham","family":"Wick","sequence":"additional","affiliation":[{"name":"UCHealth , Aurora, Colorado, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2041-7404","authenticated-orcid":false,"given":"Katy E","family":"Trinkley","sequence":"additional","affiliation":[{"name":"UCHealth , Aurora, Colorado, USA"},{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"},{"name":"Adult and Child Center for Outcomes Research and Delivery Science Center , Aurora, Colorado, USA"},{"name":"Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}]}],"member":"286","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"issue":"18","key":"2023081808482172700_ocad109-B1","first-page":"E895","article-title":"AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"issue":"9423","key":"2023081808482172700_ocad109-B2","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1016\/S0140-6736(04)16299-5","article-title":"Cyclo-oxygenase-2 inhibitors versus non-selective non-steroidal anti-inflammatory drugs and congestive heart 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