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

McKibben, S; De Simoni, A; Bush, A; Thomas, M; Griffiths, C

Journal article

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

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.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

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

McKibben, S., De Simoni, A., Bush, A., Thomas, M., & Griffiths, C. (2018). 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. Npj Primary Care Respiratory Medicine, 28(1), 14–14.

MLA Style

McKibben, S, et al. “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.” Npj Primary Care Respiratory Medicine, vol. 28, no. 1, 2018, pp. 14–14.

Chicago Style

McKibben, S, A De Simoni, A Bush, M Thomas, and C Griffiths. 2018. “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.” Npj Primary Care Respiratory Medicine 28 (1): 14–14.
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