Electronic Decision Support Tool Can Aid Asthma Care
FRIDAY, March 1, 2019 -- A new electronic decision support tool can improve the quality of asthma care in primary care settings, according to a study published online Feb. 14 in the European Respiratory Journal.
Samir Gupta, M.D., from St. Michael's Hospital in Toronto, and colleagues compared usual care (year 1) to care with the Electronic Asthma Management System (eAMS; year 2) at three Canadian primary care sites with 23 physicians treating 1,272 asthma patients aged ≥16 years receiving an asthma medication within the previous 12 months. The computerized clinical decision support system tabulated real-time patient questionnaire results (from questionnaires completed in the waiting room) to inform medical record-integrated clinician decision support.
The researchers found that action plan delivery, the primary outcome, improved from 0 to 17.8 percent among eligible patients. The action plan delivery with the intervention was also associated with a 30.5 percent increase in physician visits and an increase in assessment of asthma control level (from 4.9 to 27.7 percent; adjusted odds ratio, 8.62). Among visits by patients enrolled in the intervention, there was not a significant increase in clinician escalation of controller therapy. At baseline, a short-acting beta-agonist alone was added in 62 visits and a controller was added in 54 visits; with the intervention, this occurred in 33 and 229 visits, respectively.
"There are many barriers facing busy primary care physicians in providing the best care, including lack of time, knowledge, training, and local resources," Gupta said in a statement. "We sought to try to overcome these barriers by leveraging the power of technology."
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Posted: March 2019
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