TABLE 3.

Summary of SOE for Interventions Designed to Modify Clinician Adherence to Asthma Guidelines

Intervention	Outcome: Prescription of Controller Medications	Outcome: Self-management Education/Asthma Action Plans	Outcome: ED Visits/Hospitalizations	Outcome: Missed Days of Work/School
Clinical pharmacy support	Benefit within 3 studies with moderate magnitude of effect; SOE moderate	Benefit in 1 study with moderate magnitude of effect; SOE moderate	Unable to make a conclusion based on 1 study with imprecise results; SOE insufficient	No studies; SOE insufficient
Decision support	Benefit with large magnitude of effect; SOE moderate	Studies consistently favor intervention with large magnitude of effect; SOE moderate	Benefit with moderate magnitude of effect (larger in pre-post studies); SOE moderate	Unable to conclude due to inconsistent results; SOE insufficient
Education only	No benefit; SOE low	Small to moderate increases in a minority of studies; SOE low	No benefit; inconsistent results (reductions and increases); low SOE	No conclusion due to inconsistent and imprecise estimates of effect in 5 studies; SOE insufficient
Feedback and audit	Benefit with moderate magnitude of effect; SOE moderate	Benefit with low magnitude of effect; SOE low	No conclusion could be made due to conflicting results in few studies; SOE insufficient	No conclusion due to inconsistent results in 1 included study; SOE insufficient
Information only	Unable to make conclusion; SOE insufficient	No studies; SOE insufficient	Unable to make conclusion; no difference seen, but study quality was low; SOE insufficient	No studies; SOE insufficient
Multicomponent interventions	Benefit with moderate magnitude of effect; SOE low	Benefit, with moderate magnitude of effect (larger in observational studies); SOE low	Unable to make conclusion; although the 1 study reported a large reduction, the study quality was low; insufficient SOE	No conclusion; 1 study reported a large reduction, but study quality was low; SOE insufficient
Organizational change	Benefit with small magnitude of effect; SOE low	Two studies show benefit with moderate magnitude of effect; SOE low	No benefit with range of magnitudes of effect; SOE low	No benefit (for missed school days); SOE low
Quality improvement and pay-for-performance	No studies; SOE insufficient	Observational studies showed benefit, but the RCT did not; benefit with moderate magnitude of effect; SOE low	No benefit; SOE low	Unable to draw conclusions; 1 study (with high risk of bias) reported a nonsignificant reduction in schooldays missed; SOE insufficient