dc.contributor.author | McKibben, S | en_US |
dc.contributor.author | De Simoni, A | en_US |
dc.contributor.author | Bush, A | en_US |
dc.contributor.author | Thomas, M | en_US |
dc.contributor.author | Griffiths, C | en_US |
dc.date.accessioned | 2018-04-25T08:33:01Z | |
dc.date.available | 2018-03-09 | en_US |
dc.date.issued | 2018-04-16 | en_US |
dc.date.submitted | 2018-04-16T22:37:48.484Z | |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/36503 | |
dc.description.abstract | Computers are increasingly used to improve prescribing decisions in the management of long-term conditions however the effects on asthma prescribing remain unclear. We aimed to synthesise the evidence for the use of computerised alerts that identify excessive prescribing of short-acting beta2-agonists (SABAs) to improve asthma management for people with asthma. MEDLINE, CINAHL, Embase, Cochrane and Scopus databases (1990-2016) were searched for randomised controlled trials using electronic alerts to identify excessive prescribing of SABAs for people with asthma in primary care. Inclusion eligibility, quality appraisal (Cochrane risk of bias tool) and data extraction were performed by two independent reviewers. Findings were synthesised narratively. A total of 2035 articles were screened and four trials were eligible. Three studies had low risk of bias: one reported a positive effect on our primary outcome of interest, excessive SABA prescribing; another reported positive effects on the ratio of inhaled corticosteroid (ICS)-SABA prescribing, and asthma control; a third reported no effect on outcomes of interest. One study at high risk of bias reported a reduction in exacerbations and primary care consultations. There is some evidence that electronic alerts reduce excessive prescribing of SABAs, when delivered as part of a multicomponent intervention in an integrated health care system. However due to the variation in health care systems, intervention design and outcomes measured, further research is required to establish optimal design of alerting and intervening systems. | en_US |
dc.description.sponsorship | The authors wish to thank Asthma UK and Queen Mary University London for funding
this work as part of a PhD studentship carried out by S.M. A.D.S. is funded by a NIHR
Academic Clinical Lectureship. A.B. is a National Institute for Health Research (NIHR)
Senior Investigator and additionally was supported by the NIHR Respiratory Disease
Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust
and Imperial College London. M.T. is supported by the NIHR Collaboration for
Leadership in Applied Health Research and Care (CLAHRC) Wessex, NIHR School of
Primary Care Research and NIHR Southampton Biomedical Research Centre. C.G. is
supported by the NIHR CLAHRC North Thames at Bart’s Health NHS Trust. The views
expressed are those of the author(s) and not necessarily those of the NHS, the NIHR
or the Department of Health. This work is funded by Asthma UK and Queen Mary
University of London. | en_US |
dc.format.extent | 14 - ? | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | NPJ Prim Care Respir Med | en_US |
dc.rights | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons. org/licenses/by/4.0/. | |
dc.title | The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review. | en_US |
dc.type | Article | |
dc.rights.holder | © The Author(s) 2018 | |
dc.identifier.doi | 10.1038/s41533-018-0080-z | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/29662064 | en_US |
pubs.issue | 1 | en_US |
pubs.notes | No embargo | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 28 | en_US |
dcterms.dateAccepted | 2018-03-09 | en_US |