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Computerised guidelines are no 'magic bullet'

Effect of computerised evidence based guidelines on management of asthma and angina in adults in primary care: Cluster randomised controlled trial BMJ Volume 325, pp 941-4

BMJ

Computerised guidelines do not improve care for patients with chronic diseases, and are unlikely ever to be the "magic bullet" that answers all questions, finds a study in this week's BMJ.

Martin Eccles and colleagues set out to evaluate the use of a computerised decision support system delivering evidence based guidelines for asthma and angina in 60 general practices in north east England.

The computerised guidelines had no significant effect on consultation rates, any aspect of the process of care, or prescription of any category of drugs in patients with asthma or angina. This was probably due to low levels of use of the software, despite the system being optimised as far as was technically possible, say the authors.

Certainly in terms of implementing evidence based care, computerisation seems unlikely to be the "magic bullet" that answers all questions, and the current system could not be recommended. Even if the technical problems of producing a system that fully supports the management of chronic disease were solved, there remains the challenge of integrating the systems into primary care, where busy practitioners manage patients with complex, multiple conditions, they conclude.

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