A study published in JAMA Network Open revealed the effectiveness of a clinical decision support (CDS) system that could be implemented in primary care to reduce the cardiovascular (CV) risk factors which are common in patients with serious mental illness (SMI).

It further stressed the fact that early primary care intervention for adults with SMI was highly essential as cardiovascular (CV) disease was a leading cause for shortening their life spans compared to those without an SMI. 

The cluster-randomized clinical trial included 42 intervention clinics and 34 control clinics, which enrolled a total of 8937 patients with SMI (4922 women [55.1%]; mean [SD] age, 48.4 [13.5] years).  The intervention included a clinical decision support (CDS) system, which is a technology-based intervention that provided patient-specific information that helped to assess the modifiable CV risk factors and provide personalized treatment recommendations.

A 4% reduction was seen in the rate of increase in total modifiable CV risk over 12 months among intervention patients relative to control patients (relative rate ratio [RR], 0.96; 95% CI, 0.94-0.98). The intervention favored patients aged 18 to 29 years (RR, 0.89; 95% CI, 0.81-0.98) or 50 to 59 years (RR, 0.93; 95% CI, 0.90-0.96), Blacks (RR, 0.93; 95% CI, 0.88-0.98), or Whites (RR, 0.96; 95% CI, 0.94-0.98). Men (RR, 0.96; 95% CI, 0.94-0.99) and women (RR, 0.95; 95% CI, 0.92-0.97), and patients with any SMI subtype (bipolar disorder: RR, 0.96; 95% CI, 0.94-0.99; schizoaffective disorder: RR, 0.94; 95% CI, 0.90-0.98; schizophrenia: RR, 0.92; 95% CI, 0.85-0.99) also attained the benefits of the intervention. 

Lead author Rebecca Rossom concluded that such interventions would help clinicians to detect cardiovascular risk for patients with serious mental illness early and provide a better treatment option. Differences were observed in the intervention effectiveness by race and ethnicity.(Medscape Medical News, March 18; JAMA Network Open, March 7, 2022)