Can Computer-Generated Evidence-Based Care Suggestions Enhance Evidence-Based Management of Asthma and Chronic Obstructive Pulmonary Disease? A Randomized, Controlled Trial

• Published in: Health services research 2005-04, Vol.40 (2), p.477-498
• Main Authors: Tierney, William M, Overhage, J Marc, Murray, Michael D, Harris, Lisa E
• Format: Article
• Language: English
• Subjects: Asthma; Chronic illnesses; Electronic health records; Impact of System Interventions; Patients; Pharmacists; Physicians; Quality of life; Quality of service; Statistical analysis; Studies; Work stations
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/j.1475-6773.2005.00368.x

Translation of evidence-based guidelines into clinical practice has been inconsistent. A randomized, controlled trial of guideline-based care suggestions delivered to physicians when writing orders on computer workstations was performed. Adherence to the guidelines and clinical activity was assessed using patients' electronic medical records. Health-related quality of life, medication adherence, and satisfaction with care were assessed using telephone questionnaires. During their year in the study, patients made an average of five scheduled primary care visits. There were no differences between groups in adherence to the care suggestions, generic or condition-specific quality of life, satisfaction with physicians or pharmacists, medication compliance, emergency department visits, or hospitalizations. Physicians receiving the intervention had significantly higher total health care costs. Physician attitudes toward guidelines were mixed. Care suggestions shown to physicians and pharmacists on computer workstations had no effect on the delivery or outcomes of care for patients with reactive airways disease.