{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T08:02:48Z","timestamp":1774598568116,"version":"3.50.1"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":603,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background Computer-based decision support has been effective in providing alerts for preventive care. Our objective was to determine whether a personalized asthma management computer-based decision support increases the quality of asthma management and reduces the rate of out-of-control episodes.<\/jats:p><jats:p>Methods A cluster-randomized trial was conducted in Quebec, Canada among 81 primary care physicians and 4447 of their asthmatic patients. Patients were followed from the first visit for 3\u201333 months. The physician control group used the Medical Office of the 21st century (MOXXI) system, an integrated electronic health record. A custom-developed asthma decision support system was integrated within MOXXI and was activated for physicians in the intervention group.<\/jats:p><jats:p>Results At the first visit, 9.8% (intervention) to 12.9% (control) of patients had out-of-control asthma, which was defined as a patient having had an emergency room visit or hospitalization for respiratory-related problems and\/or more than 250 doses of fast-acting \u03b2-agonist (FABA) dispensed in the past 3 months. By the end of the trial, there was a significant increase in the ratio of doses of inhaled corticosteroid use to fast-acting \u03b2-agonist (0.93 vs. 0.69: difference: 0.27; 95% CI: 0.02\u20130.51; P = 0.03) in the intervention group. The overall out-of-control asthma rate was 54.7 (control) and 46.2 (intervention) per 100 patients per year (100 PY), a non-significant rate difference of \u22128.7 (95% CI: \u221224.7, 7.3; P = 0.29). The intervention\u2019s effect was greater for patients with out-of-control asthma at the beginning of the study, a group who accounted for 44.7% of the 5597 out-of-control asthma events during follow-up, as there was a reduction in the event rate of \u221228.4 per 100 PY (95% CI: \u221255.6, \u22121.2; P = 0.04) compared to patients with in-control asthma at the beginning of the study (\u22120.08 [95% CI: \u221210.3, 8.6; P = 0.86]).<\/jats:p><jats:p>Discussion This study evaluated the effectiveness of a novel computer-assisted ADS system that facilitates systematic monitoring of asthma control status, follow-up of patients with out of control asthma, and evidence-based, patient-specific treatment recommendations. We found that physicians were more likely to use ADS for out-of-control patients, that in the majority of these patients, they were advised to add an inhaled corticosteroid or a leukotriene inhibitor to the patient s treatment regimen, and the intervention significantly increased the mean ratio of inhaled corticosteroids to FABA during follow-up. It also reduced the rate of out-of-control episodes during follow up among patients whose asthma was out-of-control at the time of study entry. Future research should assess whether coupling patient-specific treatment recommendations, automated follow-up, and home care with comparative feedback on quality and outcomes of care can improve guideline adoption and care outcomes.<\/jats:p><jats:p>Conclusions A primary care-personalized asthma management system reduced the rate of out-of-control asthma episodes among patients whose asthma was poorly controlled at the study\u2019s onset.<\/jats:p><jats:p>Trial Registration Clinicaltrials.gov Identifier: NCT00170248 http:\/\/clinicaltrials.gov\/ct2\/show\/NCT00170248?term=Asthma&amp;spons=McGill+University&amp;state1=NA%3ACA%3AQC&amp;rank=2<\/jats:p>","DOI":"10.1093\/jamia\/ocu009","type":"journal-article","created":{"date-parts":[[2015,2,11]],"date-time":"2015-02-11T04:04:50Z","timestamp":1423627490000},"page":"773-783","source":"Crossref","is-referenced-by-count":26,"title":["Evaluating the impact of an integrated computer-based decision support with person-centered analytics for the management of asthma in primary care: a randomized controlled trial"],"prefix":"10.1093","volume":"22","author":[{"given":"Robyn","family":"Tamblyn","sequence":"first","affiliation":[{"name":"Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada"},{"name":"Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada"}]},{"given":"Pierre","family":"Ernst","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada"}]},{"given":"Nancy","family":"Winslade","sequence":"additional","affiliation":[{"name":"Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada"}]},{"given":"Allen","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, University of Ottawa, Ottawa, ON, Canada"}]},{"given":"Roland","family":"Grad","sequence":"additional","affiliation":[{"name":"Herzl Family Practice Centre, Jewish General Hospital, Montreal, QC, Canada"}]},{"given":"Robert W","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada"}]},{"given":"Sara","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada"},{"name":"Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada"}]},{"given":"Teresa","family":"Moraga","sequence":"additional","affiliation":[{"name":"Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada"}]},{"given":"Tewodros","family":"Eguale","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada"},{"name":"Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada"}]}],"member":"286","published-online":{"date-parts":[[2015,2,10]]},"reference":[{"key":"2020110613021246600_ocu009-B1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/S0749-3797(97)00049-4","article-title":"Diabetes mellitus and asthma: \u201ctwin\u201d challenges for public health and managed care systems","volume":"14","author":"Vinicor","year":"1998","journal-title":"Am J Prev Med."},{"issue":"2","key":"2020110613021246600_ocu009-B2","first-page":"185","article-title":"Trends in rates of admission to hospital and death from asthma among children and young adults in Canada during the 1980s","volume":"148","author":"Wilkins","year":"1993","journal-title":"Can Med Assoc J."},{"issue":"33","key":"2020110613021246600_ocu009-B3","first-page":"50","article-title":"A United States approach to the management of asthma in a managed care environment","volume":"6","author":"Kelloway","year":"1996","journal-title":"Eur Respir Rev."},{"key":"2020110613021246600_ocu009-B4","doi-asserted-by":"crossref","first-page":"4S","DOI":"10.1378\/chest.130.1_suppl.4S","article-title":"The Global Burden of Asthma*","volume":"130","author":"Braman","year":"2006","journal-title":"Chest."},{"key":"2020110613021246600_ocu009-B5","first-page":"12","article-title":"Lung Disease Imposes Major Costs on Canada's Economy","author":"The Conference Board of Canada","year":"15. 2012","journal-title":"News Release"},{"issue":"6","key":"2020110613021246600_ocu009-B6","first-page":"821","article-title":"Direct and Indirect Costs of Asthma in Canada, 1990","volume":"154","author":"Krahn","year":"1996","journal-title":"Can Med Assoc J."},{"key":"2020110613021246600_ocu009-B7","doi-asserted-by":"crossref","first-page":"592","DOI":"10.12968\/pnur.2012.23.12.594","article-title":"Benefits of an individual asthma action plan","volume":"23","author":"Booth","year":"2012","journal-title":"Pract Nurs."},{"key":"2020110613021246600_ocu009-B8","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1001\/archpediatrics.2007.34","article-title":"Systematic review of randomized controlled trials examining written action plans in children: what is the plan?","volume":"162","author":"Zemek","year":"2008","journal-title":"Arch Pediatr Adolesc Med."},{"key":"2020110613021246600_ocu009-B9","article-title":"Written action plans for asthma in children","volume":"3","author":"Bhogal","year":"2006","journal-title":"Cochrane Database Syst Rev."},{"key":"2020110613021246600_ocu009-B10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1136\/thorax.2003.011858","article-title":"Written action plans for asthma: an evidence-based review of the key components","volume":"59","author":"Gibson","year":"2004","journal-title":"Thorax."},{"key":"2020110613021246600_ocu009-B11","article-title":"Summary of recommendations from the Canadian Asthma Consensus Report, 1999","volume":"161","author":"Boulet","year":"2003","journal-title":"CMAJ Suppl."},{"key":"2020110613021246600_ocu009-B12","first-page":"307","volume-title":"Measures of outcome. Evidence-Based Asthma Management","author":"Fitzgerald"},{"key":"2020110613021246600_ocu009-B13","doi-asserted-by":"crossref","first-page":"3A","DOI":"10.1155\/2001\/278435","article-title":"What is new since the last (1999) Canadian Asthma Consensus Guidelines? [comment]","volume":"8","author":"Boulet","year":"2001","journal-title":"Can Respir J."},{"key":"2020110613021246600_ocu009-B14","doi-asserted-by":"crossref","first-page":"t","DOI":"10.1067\/mai.2000.108307","article-title":"Monitoring the patient with asthma: an evidence-based approach. [see comments.]. [Review] [72 refs]","volume":"106","author":"Gibson","year":"2000","journal-title":"J Allergy Clin Immunol."},{"key":"2020110613021246600_ocu009-B15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1155\/2012\/635624","article-title":"Canadian Thoracic Society 2012 guideline update: diagnosis and management of asthma in preschoolers, children and adults","volume":"19","author":"Lougheed","year":"2012","journal-title":"Can Respir J."},{"key":"2020110613021246600_ocu009-B16","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1136\/thx.53.12.1025","article-title":"First treatment with inhaled corticosteroids and the prevention of admissions to hospital for asthma","volume":"53","author":"Blais","year":"1998","journal-title":"Thorax."},{"key":"2020110613021246600_ocu009-B17","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1164\/ajrccm.158.1.9707107","article-title":"Inhaled corticosteroids and the prevention of readmission to hospital for asthma","volume":"158","author":"Blais","year":"1998","journal-title":"Am J Respir Crit Care Med."},{"key":"2020110613021246600_ocu009-B18","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1136\/thorax.57.10.880","article-title":"Regular use of inhaled corticosteroids and the long term prevention of hospitalisation for asthma","volume":"57","author":"Suissa","year":"2002","journal-title":"Thorax."},{"key":"2020110613021246600_ocu009-B19","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1056\/NEJM200008033430504","article-title":"Low-dose inhaled corticosteroids and the prevention of death from asthma","volume":"343","author":"Suissa","year":"2000","journal-title":"New Engl J Med."},{"key":"2020110613021246600_ocu009-B20","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/intqhc\/mzs043","article-title":"Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care","volume":"24","author":"Licskai","year":"2012","journal-title":"Int J Qual Health Care."},{"key":"2020110613021246600_ocu009-B21","doi-asserted-by":"crossref","first-page":"35A","DOI":"10.1155\/2001\/245261","article-title":"Control of asthma in Canada: failure to achieve guideline targets","volume":"8","author":"Chapman","year":"2001","journal-title":"Can Respir J."},{"key":"2020110613021246600_ocu009-B22","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1164\/rccm.200401-033OC","article-title":"Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study","volume":"170","author":"Bateman","year":"2004","journal-title":"Am J Respir Crit Care Med."},{"key":"2020110613021246600_ocu009-B23","doi-asserted-by":"crossref","first-page":"707","DOI":"10.4065\/84.8.707","article-title":"Managing asthma in primary care: putting new guideline recommendations into context","volume":"84","author":"Wechsler","year":"2009","journal-title":"Mayo Clin Proc."},{"key":"2020110613021246600_ocu009-B24","doi-asserted-by":"crossref","first-page":"894","DOI":"10.4065\/mcp.2011.0035","article-title":"The role of the primary care physician in helping adolescent and adult patients improve asthma control","volume":"86","author":"Yawn","year":"2011","journal-title":"Mayo Clin Proc."},{"key":"2020110613021246600_ocu009-B25","doi-asserted-by":"crossref","first-page":"62S","DOI":"10.1378\/chest.118.2_suppl.62S","article-title":"Clinical practice guidelines vs actual clinical practice: the asthma paradigm","volume":"118","author":"Crim","year":"2000","journal-title":"Chest."},{"key":"2020110613021246600_ocu009-B26","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.280.15.1339","article-title":"Effects of computer-based clinical decision support systems on physician performance and patient outcomes. A systematic review","volume":"280","author":"Hunt","year":"1998","journal-title":"JAMA."},{"key":"2020110613021246600_ocu009-B27","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1097\/00005650-199406000-00006","article-title":"Promoting screening mammography in inner-city settings: a randomized controlled trial of computerized reminders as a component of a program to facilitate mammography","volume":"32","author":"Burack","year":"1994","journal-title":"Med Care."},{"key":"2020110613021246600_ocu009-B28","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1001\/archfami.3.7.581","article-title":"Computer-based vs manual health maintenance tracking. A controlled trial","volume":"3","author":"Frame","year":"1994","journal-title":"Arch Fam Med."},{"key":"2020110613021246600_ocu009-B29","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1001\/jama.1991.03470040102030","article-title":"Promoting cancer prevention activities by primary care physicians. Results of a randomized, controlled trial","volume":"266","author":"McPhee","year":"1991","journal-title":"JAMA."},{"key":"2020110613021246600_ocu009-B30","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1001\/archinte.1994.00420170105010","article-title":"Patient-carried card prompts vs computer-generated prompts to remind private practice physicians to perform health maintenance measures","volume":"154","author":"Turner","year":"1994","journal-title":"Arch Intern Med."},{"key":"2020110613021246600_ocu009-B31","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1001\/archinte.1994.00420130107014","article-title":"Effect of computer-based alerts on the treatment and outcomes of hospitalized patients","volume":"154","author":"Rind","year":"1994","journal-title":"Arch Intern Med."},{"key":"2020110613021246600_ocu009-B32","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1136\/bmj.320.7236.686","article-title":"Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial","volume":"320","author":"Montgomery","year":"2000","journal-title":"Br Med J."},{"key":"2020110613021246600_ocu009-B33","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1177\/1460458206069761","article-title":"Computer-based decision support for pediatric asthma management: description and feasibility of the Stop Asthma Clinical System","volume":"12","author":"Shegog","year":"2006","journal-title":"Health Informatics J."},{"key":"2020110613021246600_ocu009-B34","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1748-5908-6-92","article-title":"Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review","volume":"6","author":"Roshanov","year":"2011","journal-title":"Implement Sci."},{"key":"2020110613021246600_ocu009-B35","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1136\/bmj.325.7370.941","article-title":"Effect of computerised evidence based guidelines on management of asthma and angina in primary care: cluster randomised controlled trial","volume":"325","author":"Eccles","year":"2002","journal-title":"Br Med J."},{"key":"2020110613021246600_ocu009-B36","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/j.1475-6773.2005.0t369.x","article-title":"Can computer-generated evidence-based care suggestions enhance evidence-based management of asthma and chronic obstructive pulmonary disease? A randomized, controlled trial","volume":"40","author":"Tierney","year":"2005","journal-title":"Health Serv Res."},{"key":"2020110613021246600_ocu009-B37","doi-asserted-by":"crossref","first-page":"e1095","DOI":"10.1542\/peds.2005-2160","article-title":"A randomized clinical trial of clinician feedback to improve quality of care for inner-city children with asthma","volume":"117","author":"Kattan","year":"2006","journal-title":"Pediatrics."},{"key":"2020110613021246600_ocu009-B38","doi-asserted-by":"crossref","first-page":"e770","DOI":"10.1542\/peds.2009-1385","article-title":"Electronic health record-based decision support to improve asthma care: a cluster-randomized trial","volume":"125","author":"Bell","year":"2010","journal-title":"Pediatrics."},{"key":"2020110613021246600_ocu009-B39","first-page":"549","article-title":"The medical office of the 21st century (MOXXI): effectiveness of computerized decision-making support in reducing inappropriate prescribing in primary care","volume":"169","author":"Tamblyn","year":"2003","journal-title":"CMAJ."},{"key":"2020110613021246600_ocu009-B40","first-page":"S1","article-title":"Canadian Asthma Consensus Report, 1999. Canadian Asthma Consensus Group","volume":"161","author":"Boulet","year":"1999","journal-title":"Can Med Assoc J."},{"key":"2020110613021246600_ocu009-B41","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/S0335-7457(98)80194-9","article-title":"Education of asthmatic patients. The Quebec experience","volume":"38","author":"Ernst","year":"1998","journal-title":"Revue Francaise D Allergologie et d Immunologie Clinique"},{"key":"2020110613021246600_ocu009-B42","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJM199202203260801","article-title":"The use of B-agonists and the risk of death and near death from asthma","volume":"326","author":"Spitzer","year":"1992","journal-title":"N Engl J Med."},{"key":"2020110613021246600_ocu009-B43","author":"Global Initiative for Asthma"},{"key":"2020110613021246600_ocu009-B44","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1164\/ajrccm.164.4.2009033","article-title":"Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease","volume":"164","author":"Sin","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"key":"2020110613021246600_ocu009-B45"},{"key":"2020110613021246600_ocu009-B46","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1157\/13071758","article-title":"[Cost-effectiveness of an intervention based on the Global INitiative for Asthma (GINA) recommendations using a computerized clinical decision support system: a physicians randomized trial]","volume":"124","author":"Plaza","year":"2005","journal-title":"Med Clin."},{"key":"2020110613021246600_ocu009-B47","first-page":"191","article-title":"Lessons from a randomized controlled trial designed to evaluate computer decision support software to improve the management of asthma","volume":"26","author":"McCowan","year":"2001","journal-title":"Inform Health Soc Care."},{"key":"2020110613021246600_ocu009-B48","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/00004691-200111000-00004","article-title":"Network system for automated seizure detection and contingent delivery of therapy","volume":"18","author":"Peters","year":"2001","journal-title":"J Clin Neurophysiol."},{"key":"2020110613021246600_ocu009-B49","doi-asserted-by":"crossref","first-page":"680","DOI":"10.2146\/ajhp120104","article-title":"Quality-improvement analytics for intravenous infusion pumps","volume":"70","author":"Skledar","year":"2013","journal-title":"Am J Health Syst Pharm."},{"key":"2020110613021246600_ocu009-B50","volume-title":"Envisioning the National Health Care Quality Report","author":"Corrigan","year":"2001"},{"key":"2020110613021246600_ocu009-B51","author":"Institute of Medicine of the National Academies"},{"key":"2020110613021246600_ocu009-B52","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1468-0009.2011.00628.x","article-title":"Primary health care in Canada: systems in motion","volume":"89","author":"Hutchison","year":"2011","journal-title":"Milbank Q."},{"key":"2020110613021246600_ocu009-B53","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1377\/hlthaff.2012.1087","article-title":"Ontario\u2019s primary care reforms have transformed the local care landscape, but a plan is needed for ongoing improvement","volume":"32","author":"Hutchison","year":"2013","journal-title":"Health Aff."},{"key":"2020110613021246600_ocu009-B54","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1377\/hlthaff.20.3.116","article-title":"Primary care in Canada: so much innovation, so little change","volume":"20","author":"Hutchison","year":"2001","journal-title":"Health Aff."},{"key":"2020110613021246600_ocu009-B55","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1377\/hlthaff.26.6.1586","article-title":"Unhealthy trends: the future of physician services","volume":"26","author":"Pham","year":"2007","journal-title":"Health Aff."},{"key":"2020110613021246600_ocu009-B56","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.3399\/bjgp10X501859","article-title":"Value for money and the quality and outcomes framework in primary care in the UK NHS","volume":"60","author":"Walker","year":"2010","journal-title":"Br J Gen Pract."},{"key":"2020110613021246600_ocu009-B57","author":"NHS Employers"},{"key":"2020110613021246600_ocu009-B58","doi-asserted-by":"crossref","first-page":"31","DOI":"10.24124\/c677\/2009193","article-title":"Quebec's Family Medicine Groups: Innovation and Compromise in the Reform of Front","volume":"4","author":"Pomey","year":"2009","journal-title":"Can Polit Sci Rev."},{"key":"2020110613021246600_ocu009-B59","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1377\/hlthaff.27.5.1219","article-title":"A house is not a home: keeping patients at the center of practice redesign","volume":"27","author":"Berenson","year":"2008","journal-title":"Health Aff."},{"key":"2020110613021246600_ocu009-B60","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/1077558713496318","article-title":"Patient-centered approaches to health care: A systematic review of randomized controlled trials","volume":"6","author":"McMillan","year":"2013","journal-title":"Med Care Res Rev."},{"key":"2020110613021246600_ocu009-B61","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s11606-010-1291-3","article-title":"Defining and measuring the patient-centered medical home","volume":"25","author":"Stange","year":"2010","journal-title":"J Gen Intern Med."},{"key":"2020110613021246600_ocu009-B62","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1370\/afm.1462","article-title":"Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers","volume":"11","author":"Taylor","year":"2013","journal-title":"Ann Fam Med."},{"key":"2020110613021246600_ocu009-B63","volume-title":"British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Asthma Consultation Service","author":"British Columbia Pharmacy Association"},{"key":"2020110613021246600_ocu009-B64","first-page":"186","article-title":"Asthma management in the community pharmacy setting in Ireland","volume":"34","author":"Buckley","year":"2012","journal-title":"Int J Clin Pharm."},{"key":"2020110613021246600_ocu009-B65","doi-asserted-by":"crossref","first-page":"III53","DOI":"10.1097\/01.MLR.0000076046.46152.EF","article-title":"Persistence in health expenditures in the short run: prevalence and consequences","volume":"41","author":"Monheit","year":"2003","journal-title":"Med Care."}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/4\/773\/34145996\/ocu009.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/22\/4\/773\/34145996\/ocu009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T04:32:30Z","timestamp":1717734750000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/22\/4\/773\/1745654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,10]]},"references-count":65,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2015,2,10]]},"published-print":{"date-parts":[[2015,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocu009","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,7]]},"published":{"date-parts":[[2015,2,10]]}}}