Display Settings:

Format

Send to:

Choose Destination
BMJ. 2002 Oct 26;325(7370):941.

Effect of computerised evidence based guidelines on management of asthma and angina in adults in primary care: cluster randomised controlled trial.

Author information

  • 1Centre for Health Services Research, University of Newcastle, Newcastle upon Tyne NE2 4AA, UK. martin.eccles@ncl.ac.uk

Abstract

OBJECTIVE:

To evaluate the use of a computerised support system for decision making for implementing evidence based clinical guidelines for the management of asthma and angina in adults in primary care.

DESIGN:

A before and after pragmatic cluster randomised controlled trial utilising a two by two incomplete block design. Setting: 60 general practices in north east England.

PARTICIPANTS:

General practitioners and practice nurses in the study practices and their patients aged 18 or over with angina or asthma.

MAIN OUTCOME MEASURES:

Adherence to the guidelines, based on review of case notes and patient reported generic and condition specific outcome measures.

RESULTS:

The computerised decision support system had no significant effect on consultation rates, process of care measures (including prescribing), or any patient reported outcomes for either condition. Levels of use of the software were low.

CONCLUSIONS:

No effect was found of computerised evidence based guidelines on the management of asthma or angina in adults in primary care. This was probably due to low levels of use of the software, despite the system being optimised as far as was technically possible. Even if the technical problems of producing a system that fully supports the management of chronic disease were solved, there remains the challenge of integrating the systems into clinical encounters where busy practitioners manage patients with complex, multiple conditions.

Comment in

PMID:
12399345
[PubMed - indexed for MEDLINE]
PMCID:
PMC130060
Free PMC Article

Images from this publication.See all images (3)Free text

Figure 3
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk