{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:54:15Z","timestamp":1780624455746,"version":"3.54.1"},"reference-count":37,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,1,10]]},"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Decision support systems linked to administrative databases provide a unique opportunity to monitor adherence to guidelines and target disease management strategies towards patients not receiving guideline-based therapy. The objective of this study was to evaluate the discrepancy between actual asthma treatments prescribed by primary care physicians compared to those recommended by evidence-based guidelines using a decision support tool linked to a provincial health administrative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The drug and medical services information of individuals with asthma was identified from the provincial health database and was pushed through an asthma decision support system (ADSS). Recommendations aimed at optimising asthma treatment were generated on two index dates, 15 September 2007 (index date 1) and 15 March 2008 (index date 2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care settings in a large Canadian metropolitan area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Individuals with asthma and provincial health insurance primary and secondary outcome measures: well controlled asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>16\u2005803 eligible individuals were identified on index date 1, and 18\u2005103 on index date 2. The distribution of recommendation categories was similar on both index dates. 94% were classified as well controlled and 7% as not well controlled. Among well-controlled individuals, the largest proportion was in the maintain treatment category (63.8%), followed by the maintain\/decrease treatment category (28.2%) and the decrease treatment category (2.7%). Almost all individuals who were not well controlled had the recommendation to increase treatment (88%) with a small proportion in the refer category (1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ADSS was able to identify subgroups of patients from an administrative database that could benefit from a medication review and possible change. Decision support systems linked to an administrative database can be used to identify individuals with uncontrolled asthma or prescriptions that deviate from recommended treatment. When connected to the point of care, this can provide an opportunity for physicians to intervene early.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003759","type":"journal-article","created":{"date-parts":[[2014,3,4]],"date-time":"2014-03-04T21:50:19Z","timestamp":1393969819000},"page":"e003759","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Using decision support for population tracking of adherence to recommended asthma guidelines"],"prefix":"10.1136","volume":"4","author":[{"given":"Sara","family":"Ahmed","sequence":"first","affiliation":[{"name":"Faculty of Medicine, School of Physical and Occupational Therapy, McGill University 3654 Prom. Sir William Osler, Montreal, Quebec, Canada"},{"name":"McGill University Health Center, Clinical Epidemiology, Montreal, Quebec, Canada"},{"name":"Centre de Recherche Interdisciplinaire en R\u00e9adaptation du Montr\u00e9al M\u00e9tropolitain, Montreal, Quebec, Canada"},{"name":"Faculty of Medicine, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Tamblyn","sequence":"additional","affiliation":[{"name":"McGill University Health Center, Clinical Epidemiology, Montreal, Quebec, Canada"},{"name":"Faculty of Medicine, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada"},{"name":"Faculty of Medicine, Clinical and Health Informatics, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Winslade","sequence":"additional","affiliation":[{"name":"McGill University Health Center, Clinical Epidemiology, Montreal, Quebec, Canada"},{"name":"Faculty of Medicine, Clinical and Health Informatics, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,3,4]]},"reference":[{"key":"2025121602461878000_4.3.e003759.1","first-page":"409","article-title":"Costs of asthma among US working adults","volume":"17","author":"Shenolikar","year":"2011","journal-title":"Am J Manag Care"},{"key":"2025121602461878000_4.3.e003759.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0574"},{"key":"2025121602461878000_4.3.e003759.3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3109\/02770903.2011.654022","article-title":"Impact of anxiety and depression on disease control and quality of life in asthma patients","volume":"49","author":"Urrutia","year":"2012","journal-title":"J Asthma"},{"key":"2025121602461878000_4.3.e003759.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2011.12.017"},{"key":"2025121602461878000_4.3.e003759.5","unstructured":"Glaxo Wellcome Asthma in Canada A Landmark Survey, 2000:1\u201331."},{"key":"2025121602461878000_4.3.e003759.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.07.019"},{"key":"2025121602461878000_4.3.e003759.7","first-page":"821","article-title":"Direct and indirect costs of asthma in Canada, 1990 3465","volume":"154","author":"Krahn","year":"1996","journal-title":"CMAJ"},{"key":"2025121602461878000_4.3.e003759.8","unstructured":"National Center for Health Statistics. 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