Uncontrolled asthma disproportionately affects children from minority groups and low-income, single-parent families, who may not have access to care by allergists and pulmonologists. Although evidence-based clinical practice guidelines for the management of asthma have existed for years, uniform implementation of these guidelines in the real world can be challenging.
Access to technology by patients and providers can act as the great equalizer to help us deliver better care to patients during acute visits for asthma management. In a 2019 study published in The Journal of Allergy and Clinical Immunology (JACI), investigators at 10 geographic locations across the country used a computerized decision support tool based on national guideline to implement and adjust care for children and adolescents from low-income families enrolled in several clinical trials. Using the algorithm-based guideline, 70% of patients gained asthma control within 5 weeks of the acute visit (medications were supplied to the patients in one study). The allergists and pulmonologists who reviewed the computerized results disagreed or overwrote the algorithm-based decision in only 10 % of cases.
This study demonstrates that the use of computerized algorithms can help minimize variability in decision-making, and also can be a great tool in providing evidence-based care to patients who may not have access to specialists for the management of their asthma.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.
Kercsmar CM, Sorkness CA, Calatroni A, Gergen PJ, Bloomberg GR, Gruchalla RS, Kattan M, Liu AH, O'Connor GT, Pongracic JA, Szefler SJ. A computerized decision support tool to implement asthma guidelines for children and adolescents. Journal of Allergy and Clinical Immunology. 2019 May 1;143(5):1760-8.