Lessons from a randomized controlled trial designed to evaluate computer decision support software to improve the management of asthma

Primary objective: To investigate whether computer decision support softwar e used in the management of patients with asthma improves clinical outcomes . Research design: Randomized controlled trial with practices each reporting on 30 patients with asthma over a 6 month period. Methods and procedures: 447 patients were randomly selected from practice a sthma registers managed by 17 general practices from throughout the UK. Int ervention practices used the software during consultations with these patie nts throughout the study while control practices did not. Main outcomes and results: Practice consultations, acute exacerbations of a sthma, hospital contacts, symptoms on assessment and medication use. A smal ler proportion of patients within the intervention group initiated practice consultations for their asthma: 34 (22%) vs 111 (34%), odds ratio (OR)=0.5 9, 95%, confidence interval (CI) (0.37-0.95); and suffered acute asthma exa cerbations: 12 (8%) vs 57 (17%), OR=0.43, 95% CI=0.21-0.85 six months after the introduction of the computer decision support software. There were no discernable differences in reported symptoms, maintenance prescribing or us e of hospital services between the two groups. Conclusion: The use of computer decision support software that implements g uidelines during patient consultations may improve clinical outcomes for pa tients with asthma.