Integrating asthma care guidelines into primary care electronic medical records: a review focused on Canadian knowledge translation tools.

Introduction: Asthma is one of the most common chronic respiratory diseases globally. Despite national and international asthma care guidelines, gaps persist in primary care. Knowledge translation (KT) electronic tools (eTools) exist aiming to address these gaps, but their impact on practice patterns and patient outcomes is variable. We aimed to conduct a nonsystematic review of the literature for key asthma care gaps and identify limitations and future directions of KT eTools optimised for use in electronic medical records (EMRs).
Methods: The database OVID Medline was searched (1999-2024) using keywords such as asthma, KT, primary healthcare and EMRs. Primary research articles, systematic reviews and published international/national guidelines were included. Findings were interpreted within the knowledge-to-action framework.
Results: Key asthma care gaps in primary care include under-recognition of suboptimal control, underutilisation of pulmonary function tests, barriers to care delivery, provider attitudes/beliefs, limited access to asthma education and referral to asthma specialists. Various KT eTools have been validated, many with optimisation for use in EMRs. KT eTools within EMRs have been a recent focus, including asthma management systems, decision support algorithms, data standards initiatives and asthma case definition validation for EMRs.
Conclusions: The knowledge-to-action cycle is a valuable framework for developing and implementing novel KT tools. Future research should integrate end-users into the process of KT tool development to improve the perceived utility of these tools. Additionally, the priorities of primary care physicians should be considered in future KT tool research to improve end-user uptake and overall asthma management practices.
Competing Interests: Conflict of interest: M. McFarlane has no conflicts of interest to disclose. A. Morra has received an honorarium from AstraZeneca for attendance at a 2021 PRECISION Severe Asthma Summit. M.D. Lougheed has received grants outside the submitted work paid directly to Queen's University from the Canadian Institutes of Health Research (sub-grant from Ottawa Health Research Institute), Workers Compensation Board of Manitoba, Queen's University, and GlaxoSmithKline, as well as honoraria from the Canadian Thoracic Society for co-development and co-presentation of a Severe Asthma PREP course and honoraria from AstraZeneca for participation in the Precision Program Advisory Board.
(Copyright ©The authors 2024.)