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一个基于电子医疗记录的小儿喘途径的集群随机对照试验在阿尔伯塔省的初级保健中

Melissa L Potestio¹, Heather Sharpe², David W Johnson²

¹Department of Pediatrics (Potestio, Johnson), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Sharpe), University of Alberta, Edmonton, Alta.; Ottawa Hospital Research Institute and Department of Medicine (Grimshaw), University of Ottawa, Ottawa, Ont.; Data and Analytics (Faris, Duan), Alberta Health Services; Health Quality Council of Alberta (Pow), Calgary, Alta.; Department of Family Medicine, Faculty of Medicine & Dentistry (Cave), University of Alberta, Edmonton, Alta. mlpotest@ucalgary.ca.

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

|November 24, 2025

概括

针对儿科喘的新电子病历 (EMR) 途径没有增加控制器药物处方或在初级保健中分发. 未来的干预措施可能需要积极的警报和紧急护理整合,以更好地管理喘.

科学领域:

儿科喘管理儿科喘管理
临床信息学临床信息学
提高初级保健实践的改善

背景情况:

初级保健医生往往低估了喘控制和低估了儿童的控制药物.
为了解决这些缺陷,开发了一种集成到电子病历 (EMR) 的儿科喘临床途径.
这项研究旨在评估这种基于EMR的途径对儿科喘患者控制剂药物使用的影响.

研究的目的:

评估嵌入EMR的儿科喘临床途径对控制器药物处方和发放的有效性.
评估包括EMR途径,医生教育和初级保健中喘管理人员培训在内的多方面的干预.

主要方法:

一个集群随机对照试验在阿尔伯塔省的初级保健实践中使用Wolf或Med Access EMR进行.
干预组接受了基于EMR的喘途径,基于网络的教育和人员培训;对照组接受了标准护理.
从EMR和行政数据集中提取数据,主要结果是儿童处方和分发控制器药物的比例.

主要成果:

干预措施没有显著增加儿童处方控制药物的比例 (平均差异为4.3%,95%CI -2.0%至10.5%).
同样,在分配控制药物的儿童比例上也没有显著变化 (平均差异为-0.1%,95%CI-7.1%至6.9%).

结论:

基于EMR的多方面的干预措施并没有改善初级保健中对儿科喘的处方或分发的控制药物.
有效的干预可能需要在EMR中进行积极的警报,以及针对步行和紧急护理设置的有针对性的策略.

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