OBJECTIVES: In China most of diabetes patients were treated in county or lower level hospitals. However in these hospitals physicians vary in professional skills and disease manangement experience. Clinical decision support system (CDSS) can provide the efficient protocol of diabetes diagnosis, treatment and management for doctors according to the latest clinical guidelines. In this study, we evaluated the type 2 diabetes (T2D) patients management effectiveness before and after receiving CDSS in a county hospital.

METHODS: Data were obtained from Yongcheng Central HospitalEMR system. Patients who meet the following criteria were enrolled：T2D disgnosis, not using CDSS at first visit in 2021, having complete demographic information, diagnosis and treatment information, receiving 1st or more CDSS intervention within the following 3 months. Outcome measures included fasting plasma glucose (FPG), HbA1c, body mass index (BMI), and comorbidities. Statistical analysis was performed using SPSS (Version 21.0)

RESULTS: In 2021, 531 patients were diagnosed with T2D at baseline. The diagnostic rates of comorbidities (hypertension, coronary heart disease, stroke, chronic kidney disease) were 43.13%, 46.33%, 13.56% and 5.27% respectively without using CDSS at baseline, and 51.86%, 63.36%, 14.69% and 5.66% respectively in patients during the first visit with CDSS. The diagnostic rates of patients with hypertension and coronary heart disease were significantly different (P<0.05). In 77 patients who had at least two CDSS records with 3-month intervals, FPG, HbA1c and BMI were (7.22±2.16) mmol/L, (8.23±3.96) %, (23.16 ± 2.08) kg/m² respectively at the first visit, and were (6.62 ± 2.22) mmol/L, (6.58 ± 0.82) % and (23.25 ± 6.99) kg/m² respectively at the second visit. Between the two visits, FPG and HbA1c were significantly improved (P=0.046, <0.001).

CONCLUSIONS: CDSS application in the county hospitals can benefit blood glucose and comorbidity management. Due to the limitations of sample size and short-term observation, further analysis in more patients and long duration are needed.