Enhancing Comorbidity Management in Patients With Hemorrhagic Stroke via an Electronic Health Record-Linked Best Practice Alert: A Pre/Post Study

We conducted a prospective cohort study comparing a historical cohort of 314 consecutive patients with primary intracerebral hemorrhage (2016-2019) with a prospective intervention cohort of 296 patients with hemorrhagic stroke (2023-2024) at a single tertiary care center. The intervention was composed of an electronic health record-deployed best practice alert to prompt providers to order low-density lipoprotein cholesterol (LDL-C) and glycated hemoglobin (HbA1c) levels. We compared the cumulative incidence of LDL-C and HbA1c evaluation before and after intervention through Gray's test and assessed the effectiveness of the intervention using a multivariable Fine and Gray model, adjusted for relevant confounders. Finally, we evaluated changes in the treatment intensification of suboptimal LDL-C and HbA1c levels between the 2 periods using χ2 and Fisher exact tests.