The Electronic Asthma Management System (eAMS) improves primary care asthma management

Area of Science:

• Primary Care Research
• Health Informatics
• Respiratory Medicine

Background:

• Suboptimal asthma control is common due to evidence-practice gaps.
• Effective management strategies are needed to improve patient outcomes.

Purpose of the Study:

• To evaluate the impact of a computerised clinical decision support system, the Electronic Asthma Management System (eAMS), on asthma care quality.
• To address major care gaps in adult asthma management.

Main Methods:

• A 2-year interrupted time-series study comparing usual care with the eAMS intervention at three Canadian primary care sites.
• The eAMS involved patient questionnaires and real-time data processing for clinician decision support.
• Included adults (≥16 years) receiving asthma medication in the past 12 months.

Main Results:

• Action plan delivery increased from 0% to 17.8% (p<0.0001), with a 30.5% rise in physician visits incorporating action plans.
• Assessment of asthma control level rose significantly from 4.9% to 27.7% of eligible visits (adjusted OR 8.62).
• Controller therapy escalation increased substantially (p<0.001) with the eAMS, while short-acting β-agonist alone additions decreased.

Conclusions:

• The Electronic Asthma Management System demonstrably improved asthma quality of care in real-world primary care settings.
• Further strategies are needed to enhance clinician adoption of the eAMS.
• A randomized controlled trial is recommended to assess the eAMS's impact on patient-level outcomes.