PharmacoEconomics & Outcomes News 263 - 20 May 2000

Handheld computer assists inasthma

A handheld, computer-based decision support systemfor implementing the American Academy of Pediatrics(AAP) asthma guidelines improves physician adherenceto the guidelines in a nonhospital setting, reportinvestigators from Yale School of Medicine,Connecticut, US.

Their prospective study evaluated the practicepatterns of 9 physicians treating children (mean age 11years) with acute exacerbations of asthma before (n =91) and after (74) the use of the handheld computer-assist device was introduced. Compared withbeforehand, physicians’ adherence to the AAP asthmaguideline recommendations increased after thehandheld system was introduced; peak expiratory flowrate and oxygen saturation were measured morefrequently, nebulisations were administered more oftenand prescriptions for corticosteroids tended to increase.

However, physician charges rose considerably afterthe computer-based handheld system was introduced,and there was a significant increase in the duration ofoffice visits. In addition, patient outcomes were similarbefore and after the handheld system was introduced,with little difference in the number of children whomissed school, the number of children’s caretakers whomissed work and the number of children that revisitedtheir physician.Shiffman RN, et al. A guideline implementation system using handheld computersfor office management of asthma: effects of adherence and patient outcomes.Pediatrics 105: 767-773, Apr 2000 800817128

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PharmacoEconomics & Outcomes News 20 May 2000 No. 2631173-5503/10/0263-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved