Asthma Crisis in Paediatrics: Impact of a Care Pathway in Primary and Hospital Care
- Conditions
- Asthma in ChildrenImplementation Science
- Interventions
- Behavioral: The implementation strategy to encourage the adoption of the Care Pathway
- Registration Number
- NCT06437444
- Lead Sponsor
- Basque Health Service
- Brief Summary
This study aims to evaluate the effect of the implementation of the new Asthma Integrated Care Pathway in the Basque Healthcare Service for the improvement of care for children with asthma attacks and the reduction of variability between professionals and care settings in this care practice. Asthma is the most common chronic disease in children and has a major impact on people's quality of life. The Asthma Integrated Care Pathway is a structured multidisciplinary care plan that details the essential steps in the care of patients with mild-moderate asthma attacks and the coordinated practice of the agents involved as dictated by the evidence. This pathway will include quality indicators of compliance with diagnostic criteria, assessment of severity and prescription of drugs, as well as the experience of families and professionals, which have been collected in meetings designed for this purpose.
The study consists in a mixed methods implementation trial with two phases:
1. Phase I: a quantitative evaluation will be carried out to assess implementation outcomes at the professional level through a pretest-posttest quasi-experimental study with paired control group, with a ratio of 1:2. The primary outcome variable will be the overall percentage of bronchodilator treatment with a spacer chamber in children diagnosed with mild-moderate asthma attacks. We will also include as outcomes to be measured the registration rate of the Pulmonary Score, the recording rate of the assessment of persistent asthma symptoms, and the rate of initiation of background treatment in children with persistent asthma symptoms. These variables will be analysed using differences in pre- and post-intervention outcome measures between the intervention and control groups.
2. Phase II: a qualitative evaluation will be carried out through a structured process with discussion groups focused on the identification of the main barriers and facilitators for the provision of recommended clinical practice related to asthmatic crisis in mild-moderate cases established by the Asthma Integrated Care Pathway. A purposive sample of paediatricians stratified by level of care and service organisations will be recruited to ensure that all views are represented in the discussion groups. The structured script will be designed with questions to explore each of the domains of the Theoretical Domains Framework (TDF).
The study will be carried out mainly in two integrated healthcare organizations (IHO), which are made up of two primary care areas and the paediatric reference hospital emergency department of both areas, as well as the hospitalisation, intensive care and paediatric pneumology departments of said hospital, to extend in the future the Asthma Integrated Care Pathway to the rest of the Basque Health Service IHOs.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 249
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Asthma Care Pathway group The implementation strategy to encourage the adoption of the Care Pathway All the primary care and hospital pediatricians of the two Integrated Hospital Organizations (IHO) (Barakaldo-Sestao and Ezkerraldea-Enkarterri-Cruces) where the care pathway will be implemented. 83 participants in total.
- Primary Outcome Measures
Name Time Method Percentage of bronchodilator treatment from baseline to 12 months, 24 months and 36 months The overall percentage of bronchodilator treatment with a spacer chamber in children diagnosed with mild-moderate asthma attacks.
- Secondary Outcome Measures
Name Time Method Pulmonary Score registration from baseline to 12 months, 24 months and 36 months Rate of Pulmonary Score registration in children diagnosed with mild-moderate asthma attacks, at all levels of care.
Assessment and recording of persistent asthma symptoms. from baseline to 12 months, 24 months and 36 months Rate of assessment and recording of persistent asthma symptoms in children diagnosed with mild-moderate asthma attacks by ussing the PACT form (Pediatric Asthma Control Tool).
Initiation of background treatment in children with persistent asthma symptoms from baseline to 12 months, 24 months and 36 months Rate of initiation of background treatment in children who have been assessed and registered with persistent asthma symptoms.
Trial Locations
- Locations (1)
Primary Care Research Unit of Bizkaia
🇪🇸Barakaldo, Bizkaia, Spain