Lessons from a randomized controlled trial designed to evaluate computer decision support software to improve the management of asthma.
OBJECTIVE
To investigate whether computer decision support software used in the management of patients with asthma improves clinical outcomes.


METHODS
Randomized controlled trial with practices each reporting on 30 patients with asthma over a 6 month period.


METHODS
447 patients were randomly selected from practice asthma registers managed by 17 general practices from throughout the UK. Intervention practices used the software during consultations with these patients throughout the study while control practices did not.


RESULTS
Practice consultations, acute exacerbations of asthma, hospital contacts, symptoms on assessment and medication use. A smaller proportion of patients within the intervention group initiated practice consultations for their asthma: 34 (22%) vs 111 (34%), odds ratio (OR) = 0.59, 95% confidence interval (CI) (0.37-0.95); and suffered acute asthma exacerbations: 12 (8%) vs 57 (17%), OR = 0.43, 95% CI = 0.21-0.85 six months after the introduction of the computer decision support software. There were no discernable differences in reported symptoms, maintenance prescribing or use of hospital services between the two groups.


CONCLUSIONS
The use of computer decision support software that implements guidelines during patient consultations may improve clinical outcomes for patients with asthma.
McCowan
C
C
University of Dundee, Tayside Centre for General Practice, UK. c.mccowan@dundee.ac.uk
Neville
R G
RG
Ricketts
I W
IW
Warner
F C
FC
Hoskins
G
G
Thomas
G E
GE
D001249:Asthma / Q000628:therapy*; D020000:Decision Support Systems, Clinical; D019468:Disease Management; D006801:Humans; D012984:Software; D016896:Treatment Outcome; D006113:United Kingdom