eAMS-Eco: Implementation of a Tool for Climate Conscious Inhaler Prescribing

The goal of this study is to determine whether an 'eco' version of the Electronic Asthma Management System (eAMS) can reduce inhaler carbon emissions in primary care, in patients with asthma. The existing eAMS uses patient-specific criteria (asthma control, asthma flare-up risk, and current medications) to provide guideline-based computerized clinical decision support to clinicians, to improve the delivery of asthma care. The eAMS-Eco includes embedded cues and messaging on the environmental impact of inhaler medications and links to a patient-friendly conversation aid that facilitates shared decision-making and climate-conscious prescribing. The study will evaluate the implementation of the eAMS-Eco in four primary care clinics that have been using the existing eAMS, using an interrupted time-series analysis (one year pre- and post-launch of the eAMS-Eco). The investigators will assess system uptake and user feedback on the eAMS-Eco, as well as changes in inhaler prescriptions (including resulting changes in carbon emissions and costs) and changes in asthma control, in the implementation period (eAMS-Eco) compared to the baseline period (eAMS).

Clinician eligibility criteria: Inclusion criteria: -Active clinician at one of the four study sites during the study period Patient eligibility criteria: Inclusion criteria: * Patient at one of the four study sites with a visit during the study period * Diagnosis of asthma (using validated algorithm for primary care of 1. asthma billing code (493) in the past 3 years OR asthma in the cumulative patient profile (CPP) and 2. prescription for an inhaler in the past year