Cited by 354Clinical practice guidelines implementationElectronic Health Records SystemsHealth Sciences Research and Education

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

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Eccles, M.·2002·BMJ

DOI 10.1136/bmj.325.7370.941PMC PMC130060

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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.

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(1992) · PubMed · Cited by 33,716
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Brooks, R. (1996) · Health Policy · doi:10.1016/0168-8510(96)00822-6 · Cited by 5,815
Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings
Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998) · BMJ · doi:10.1136/bmj.317.7156.465 · Cited by 2,396
Effects of Computer-Based Clinical Decision Support Systems on Physician Performance and Patient Outcomes
Hunt, D. L., Haynes, R. B., Hanna, S., & Smith, K. (1998) · JAMA · doi:10.1001/jama.280.15.1339 · Cited by 1,684
Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease.
Spertus, J., Winder, J. A., Dewhurst, T. A., Deyo, R., Prodzinski, J., McDonnell, M., & Fihn, S. (1995) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(94)00397-9 · Cited by 1,413
Measuring Quality of Life in Asthma
Juniper, E. F., Guyatt, G. H., Ferrie, P. J., & Griffith, L. E. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/147.4.832 · Cited by 887
Validation of a Standardized Version of the Asthma Quality of Life Questionnaire
Juniper, E. F., Buist, A. S., Cox, F. M., Ferrie, P. J., & King, D. (1999) · CHEST Journal · doi:10.1378/chest.115.5.1265 · Cited by 713
Developing and implementing clinical practice guidelines.
Grimshaw, J., Freemantle, N., Wallace, S. A., Russell, I. T., Hurwitz, B., Watt, I., Long, A., & Sheldon, T. (1995) · BMJ Quality & Safety · doi:10.1136/qshc.4.1.55 · Cited by 467
Evaluation Methods in Medical Informatics
Friedman, C. P., & Wyatt, J. C. (1997) · Computers and medicine · doi:10.1007/978-1-4757-2685-5 · Cited by 450
Sample Size Calculations for Cluster Randomised Trials
Campbell, M., Grimshaw, J., Steen, N., & Changing Professional Practice in Europe Group (EU BIOMED II Concerted Action) (2000) · Journal of Health Services Research & Policy · doi:10.1177/135581960000500105 · Cited by 298

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*Effect sizes; estimates of ratio of mean number of consultations for participants in practices that received computerised decision support system to mean number of consultations for participants in control practices based on Poisson regression model. †Patients who consulted after intervention and had not had variable recorded anywhere in their clinical record during period before intervention. Primary care page 4 of 7 BMJ VOLUME 325 26 OCTOBER 2002 bmj.com on 17 July 2023 by guest. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj.325.7370.941 on 26 October 2002. Downloaded from All patients 516 (43); 511 (43) 492 (42); 517 (45) 0.94 (0.67 to 1.33) Patients who consulted 515 (45); 510 (45) 491 (45); 516 (47) 0.94 (0.66 to 1.34) Compliance checked: All patients 426 (36); 442 (37) 446 (38); 471 (41) 0.82 (0.58 to 1.15) Patients who consulted 425 (37); 441 (39) 445 (40); 470 (43) 0.82 (0.58 to 1.16) Inhaler technique assessed: All patients 203 (17); 224 (19) 234 (20); 262 (23) 0.8 (0.5 to 1.28) Patients who consulted 203 (18); 224 (20) 233 (21); 262 (24) 0.81 (0.5 to 1.28) Asthma education, action plan, or both: All patients 79 (7); 60 (5) 108 (9); 78 (7) 0.84 (0.4 to 1.74) Patients who consulted 79 (7); 60 (5) 108 (10); 78 (7) 0.81 (0.39 to 1.67) Smoking status known: All patients 285 (24); 370 (32) 305 (26); 367 (32) 0.97 (0.65 to 1.45) Patients who consulted 285 (25); 369 (33) 303 (28); 367 (33) 0.98 (0.66 to 1.46) Smoking cessation advice or nicotine replacement therapy: All patients 57 (5); 81 (7) 68 (6); 103 (9) 0.75 (0.45 to 1.26) Patients who consulted 57 (5); 81 (8) 68 (6); 103 (9) 0.76 (0.46 to 1.27)
*Guideline specifically recommended not using these combinations. Table 5 Drugs prescribed for patients with asthma before and after introduction of computerised decision support system. Values are numbers (percentages) unless stated otherwise Computerised system (n=1391) Controls (n=1385) Odds ratio (95% CI) Short acting 2 agonists 1138 (82); 1112 (80) 1160 (84); 1108 (80) 1.04 (0.83 to 1.31) Inhaled corticosteroids 1065 (77); 1001 (72) 1004 (73); 975 (70) 0.95 (0.78 to 1.16) Long acting 2 agonists 181 (13); 198 (14) 164 (12); 183 (13) 0.84 (0.59 to 1.20) Oral steroids 317 (23); 316 (23) 286 (21); 297 (21) 1.0 (0.82 to 1.22) Oral bronchodilators 100 (7); 95 (7) 120 (9); 119 (9) 1.38 (0.56 to 3.39) Primary care page 5 of 7 BMJ VOLUME 325 26 OCTOBER 2002 bmj.com on 17 July 2023 by guest. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj.325.7370.941 on 26 October 2002. Downloaded from

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Background
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Taljaard, M., Weijer, C., & Grimshaw, J. (2013) · doi:10.1002/9781118413555.ch34 · Cited by 4
Evaluating and Improving Physician Prescribing
Majumdar, S. R., Lipton, H. L., & Soumerai, S. B. (2012) · Pharmacoepidemiology · doi:10.1002/9781119959946.ch25 · Cited by 3
Leitlinien
Härter, M. C., & Bermejo, I. (2008) · Springer eBooks · doi:10.1007/3-540-32221-3_21 · Cited by 4
The effect of risk attitude and uncertainty comfort on primary care physicians' use of electronic information resources
Fridsma, D. B., & McKibbon, K. A. (2005) · Cited by 3
Workflow technology to enrich a computerized clinical chart with decision support facilities.
Panzarasa, S., Quaglini, S., Cavallini, A. M., Micieli, G., Pernice, C., Pessina, M., & Mario Stefanelli, A. (2006) · PubMed Central · Cited by 3
The balanced incomplete block design is not suitable for the evaluation of complex interventions
Trietsch, J., Leffers, P., van Steenkiste, B., Grol, R. P. T. M., & van der Weijden, T. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.07.006 · Cited by 3
Audit of Health Data Captured Routinely in Primary Healthcare for the Clinical Decision Support System PREDICT (PREDICT CVD-4)
Riddell, T., Kenealy, T. W., Wells, S., Jackson, R., & Broad, J. (2008) · Cited by 3
Requirement analysis for a nursing decision support system
Chang, Y., Khoo, C. S. G., Nourbakhsh, A., & Gan, A. (2009) · IEEE Toronto International Conference Science and Technology for Humanity · doi:10.1109/tic-sth.2009.5444526 · Cited by 3
“For example, an evaluation of a CDSS that implemented clinical guidelines in 31 general practice settings in England found little change in health outcomes because doctors did not go beyond the first screen [ 5 ]! Another study found that doctors tended not to follow advice based on a guideline when they disagreed wit…”
Method
Societal Issues
Berman, J. J. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-404576-7.00014-9 · Cited by 3
The nationwide retrospective cohort study by Health Insurance Review and Assessment Service proves that asthma management decreases the exacerbation risk of asthma
Kim, N.-E., Lee, S., Kim, B. Y., Hwang, A. G., Shin, J. H., Yang, H., & Won, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-81022-z · Cited by 3
Smart phone as a medium to access medical information: a field study of military physicians
Tétard, F., Han, S., Harkke, V., & Collan, M. (2008) · Cited by 2
THE STUDY OF CLINICAL DECISION SUPPORT SYSTEMS ROLE IN HEALTH CARE (1980-2010)
Zohreh, O., & Hadianfard, A. M. (2011) · Jentashapir Journal of Health Research · Cited by 2
A Novel Personalized Fall Risk Calculator: A Prototype for Improving the Safety of Prescribing Through Computerized Decision Support
Tamblyn, R. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-32304-6_20 · Cited by 2
Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city
Lehto, M. T., Pitkälä, K. H., Rahkonen, O., Laine, M. K., Raina, M., & Kauppila, T. (2021) · SAGE Open Medicine · doi:10.1177/20503121211036117 · Cited by 2
The Use of Computerized Decision Support Systems in Preventive Cardiology—Principal Results from the National Precard® Survey in Denmark
Bonnevie, L., Thomsen, T. F., & Jørgensen, T. (2005) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/204748730501200108 · Cited by 2
Implementing an Evidence-based Hypertension Guideline into Finnish Primary Care Nursing
Alanen, S. (2009) · UTUPub (University of Turku) · Cited by 2
The effects of selection defaults on the ordering practices of clinicians using an Electronic Medical Record
Probst, A. C. (2011) · Holmes Museum Of Anthropology (Wichita State University) · Cited by 2
Improving the legal and regulatory climate for telemedicine and e-health
Terry, N. P. (2003) · International Congress Series · doi:10.1016/s0531-5131(03)00484-9 · Cited by 2
Investigating infant deaths
Platt, M. W. (2005) · BMJ · doi:10.1136/bmj.330.7485.206 · Cited by 2
“So will the protocol recommended by Baroness Kennedy make a difference? Here we are on uncertain ground. The mere existence of a protocol is not a guarantee that it will be followed, however much it might be “compulsory”; the history of protocolology is one of worthy aspirations that largely fail to change practice in…”
Models of chronic disease management in primary care for patients with mild to moderate asthma or COPD
Cranston, J. M., Crockett, A. J., Moss, J. R., Pegram, R. W., & Stocks, N. (2006) · Adelaide Research & Scholarship (AR&S) (University of Adelaide) · Cited by 2
Development of data-driven clinical pathways: the big data clinical evidence-based pathways
Cui, X. L., Sui, M., Xie, H., Chen, W., Tian, W., Wang, P., Jiang, X., Fu, C., & Xu, S. Q. (2025) · BMJ Health & Care Informatics · doi:10.1136/bmjhci-2024-101312 · Cited by 1
A qualitative interview study to investigate opportunities for improvement in routine asthma care using a clinical decision support system
Tibble, H., García-Iglesias, J., & Chung, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-25438-x · Cited by 1
Normalisation Process Theory: Its consolidation and application in implementation research and practice
May, C. R., Finch, T. L., & Rapley, T. (2026) · NIHR Open Research · doi:10.3310/nihropenres.14315.1 · Cited by 1
ICT for Patient Safety: Towards a European Research Roadmap
Stroetmann, V. N., Spichtinger, D., Stroetmann, K. A., & Thierry, J. P. (2006) · Lecture notes in computer science · doi:10.1007/11946465_44 · Cited by 1
“computer-based guidelines on the management of angina and asthma ) [19].”
Background
Consultation skills and decision making
Baird, A. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511861123.005 · Cited by 1
Initial Assessment of an Internet‐Based Medication Record
Calabretto, J., & Warren, J. (2005) · Journal of Pharmacy Practice and Research · doi:10.1002/j.2055-2335.2005.tb00315.x · Cited by 1
Computer-Based Applications in the Management of Asthma
Shegog, R., & Sockrider, M. M. (2009) · Springer eBooks · doi:10.1007/978-0-387-78285-0_10 · Cited by 1
Analysis of current clinical decision support system: the perspective of a clinician
Cao, Y., & Zhu, Y. (2022) · International Conference on Biomedical and Intelligent Systems (IC-BIS) · doi:10.1117/12.2660600 · Cited by 1
“Ignoring the causal reasoning pattern will inevitably lead to the failure of CDSS in coordination with clinical work.”
BackgroundInfluential
Digitalisierung und Clinical Decision Tools
Reich, C., Frey, N., & Giannitsis, E. (2024) · Herz · doi:10.1007/s00059-024-05242-5 · Cited by 2
Big Data Failures and How to Avoid (Some of) Them
Berman, J. J. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-815609-4.00015-7 · Cited by 1
From Study Questions to Study Design: Exploring the Full Range of Informatics Study Types
Friedman, C. P., Wyatt, J. C., & Ash, J. S. (2022) · Health informatics · doi:10.1007/978-3-030-86453-8_3 · Cited by 1
Association of Asthma Exacerbation Risk and Physician Time Expenditure With Provision of Asthma Action Plans and Education for Pediatric Patients
Afolabi, T. M., & Fairman, K. A. (2022) · The Journal of Pediatric Pharmacology and Therapeutics · doi:10.5863/1551-6776-27.3.244 · Cited by 1

Authors: Eccles, M.
Affiliations: Newcastle University (GB)
Corresponding author: Eccles, M.
Venue: BMJ
Publisher: BMJ
Published: 2002-10-26
Volume: 325
Issue: 7370
Pages: 941-941
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.325.7370.941
PMC: PMC130060
OpenAlex: W1996469473
Cited by: 354
References: 24
Citations by year: 2026: 3 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 9 · 2021: 7 · 2020: 7 · 2019: 5 · 2018: 9 · 2017: 7 · 2016: 12 · 2015: 10 · 2014: 14 · 2013: 19 · 2012: 14
FWCI: 29.39
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Newcastle University ePrints (Newcastle Univesity)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords: computerised decision support, clinical guidelines, asthma management, angina management, guideline adherence, primary care, general practitioners, practice nurses, drug prescribing, patient-reported outcomes, chronic disease management
MeSH terms: Angina Pectoris, Asthma, Decision Making, Computer-Assisted, Family Practice, Humans, Treatment Outcome, Practice Guidelines as Topic, Evidence-Based Medicine, Guideline Adherence

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

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