Effectiveness of a computer-assisted asthma management program on physician adherence to guidelines.
OBJECTIVE
Asthma is an example of a chronic disease for which there are evidence-based guidelines for primary care. The authors undertook this study to demonstrate that physicians' use and adherence to asthma management guidelines are improved when the guidelines are furnished in a computer-based format.


METHODS
Based on established guidelines, the authors devised a practical and simple computer-assisted program focused on asthma treatment and monitoring. They then undertook a preliminary investigation, "Easy Asthma Management (EAM)" study, using this program. Finally, the authors evaluated the program's effectiveness by measuring clinical outcomes and changes in prescription patterns before and after the study.


RESULTS
A total of 4682 asthma patients followed by 377 physicians were recruited, and 2187 completed the study (46.7%). The means of diurnal and nocturnal symptom scores were significantly reduced after a 3-month enrollment in the EAM study. Interestingly, the fraction of prescriptions for oral beta(2)-agonists, oral methylxanthines, and systemic steroids (oral or injection) significantly decreased after the EAM study (p = .02, p <.001, p <.001, respectively), whereas the fraction of prescriptions for inhaled forms of steroids combined with beta(2)-agonists increased significantly (p <.001).


CONCLUSIONS
These findings suggest that a computer-assisted asthma management program can be used to improve the clinical outcomes of patients with asthma, and increase physician adherence to established guidelines.
Cho
Sang-Heon
SH
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jeong
Jae-Won
JW
Park
Heung-Woo
HW
Pyun
Bok-Yang
BY
Chang
Suk-Il
SI
Moon
Hee-Bom
HB
Kim
You-Young
YY
Choi
Byoung Whui
BW
D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D016009:Chi-Square Distribution; D003658:Decision Making, Computer-Assisted; D019468:Disease Management; D005541:Forced Expiratory Volume; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D010820:Physicians
D018927:Anti-Asthmatic Agents