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基于计算机的儿童哮喘管理决策支持:“停止哮喘临床系统”的描述与可行性

Computer-based decision support for pediatric asthma management: description and feasibility of the Stop Asthma Clinical System.

作者信息

Shegog Ross, Bartholomew Leona K, Sockrider Marianna M, Czyzewski Danita I, Pilney Susan, Mullen Patricia Dolan, Abramson Stuart L

机构信息

Center for Health Promotion and Prevention Research, UT-School of Public Health, 7000 Fannin, Suite 2668, Houston, TX 77030, USA.

出版信息

Health Informatics J. 2006 Dec;12(4):259-73. doi: 10.1177/1460458206069761.

Abstract

Clinical guidelines can assist in the management of asthma. Decision support systems (DSSs) can enhance adherence to clinical guidelines but tend not to provide clinicians with cues for behavioral change strategies to promote patient self-management. The Stop Asthma Clinical System (SACS) is a DSS designed for this purpose. To assess feasibility, seven clinicians used SACS to guide well visits with 26 predominantly persistent pediatric asthma patients. Data were collected via survey and in-depth semi-structured interviews. SACS improved assessment of asthma severity and control, classification of and intervention in medicine and environmental trigger management problems, and development of an action plan (all p < 0.05). Clinician-patient communication was enhanced. The primary challenge was that SACS increased clinic visit time. SACS can enhance clinician behavior to improve patient asthma self-management, but more studies are indicated to mitigate temporal constraints and evaluate impact on clinician and patient communication and behavior as well as clinical outcomes.

摘要

临床指南有助于哮喘的管理。决策支持系统(DSS)可提高对临床指南的依从性,但往往无法为临床医生提供促进患者自我管理的行为改变策略提示。哮喘临床停止系统(SACS)就是为此目的而设计的决策支持系统。为评估其可行性,7名临床医生使用SACS指导了对26名主要为持续性小儿哮喘患者的健康检查。通过调查和深入的半结构化访谈收集数据。SACS改善了哮喘严重程度和控制情况的评估、药物及环境触发因素管理问题的分类与干预以及行动计划的制定(所有p<0.05)。临床医生与患者之间的沟通得到了加强。主要挑战在于SACS增加了门诊就诊时间。SACS可增强临床医生的行为,以改善患者的哮喘自我管理,但需要更多研究来缓解时间限制,并评估其对临床医生与患者沟通及行为以及临床结果的影响。

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