Effectiveness of A Computer-Assisted Asthma Management Program on Physician Adherence to Guidelines

Abstract

Background and 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.