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Using an Online Patient Monitoring System to Improve Care for Children With Chronic Conditions

Not Applicable
Completed
Conditions
Autism Spectrum Disorder
Attention Deficit Hyperactivity Disorder
Asthma
Depression
Epilepsy
Interventions
Other: TriVox for clinical care
Registration Number
NCT02097355
Lead Sponsor
Boston Children's Hospital
Brief Summary

TriVox Health is an online system designed to make it easy for healthcare providers to monitor patients' disease symptoms and functioning over time and in between in-person visits (http://www.youtube.com/watch?v=VR1vcbx0Ef4). Using combined quality improvement and randomized clinical trial methods, we will evaluate the impact of TriVox on the health outcomes, patient/family experience of care, and healthcare utilization for children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), asthma, autism, depression, and epilepsy.

Detailed Description

TriVox Health is a web-based patient management and monitoring system designed to track patients' disease symptoms and response to therapy over time. TriVox Health enables clinics to use electronic surveys to gather data remotely from multiple responders, including patients, parents/guardians, school personnel and ancillary providers, and view the responses in a timely manner via graphical, tabular, and narrative summary formats.

This quality improvement (QI) initiative will implement TriVox as the standard of care for all patients who receive care for ADHD, asthma, autism, depression, and epilepsy within seven ambulatory specialties at Boston Children's Hospital. Patients and families will use TriVox to report on patient health status and will complete clinically-reTriVoxlevant questionnaires at routine intervals. Providers will use the information collected through TriVox to inform their clinical care of the patient/family.

To evaluate the effectiveness of TriVox, we will conduct a 24-month phased, cluster randomized controlled trial (RCT) where we randomize providers to "active" vs. "delayed-start" to TriVox use, with patients clustered by provider (within specialties) for analytic purposes. Delayed-start providers will crossover to active TriVox use after 12 months. Patients/families will complete additional surveys in order to assess the system's actual or potential effects on patient/family-provider interactions, healthcare utilization and costs.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
946
Inclusion Criteria
  • Pediatric patients with clinical diagnosis of ADHD, asthma, autism, depression, and/or epilepsy
  • Patient receives care for these diagnoses from providers in participating ambulatory clinics (Primary Care, Adolescent Medicine, Developmental Medicine, Neurology, Psychiatry)
  • Patient's primary caregiver enrolled in TriVox
Exclusion Criteria
  • None

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
TriVox ActiveTriVox for clinical careProvider using TriVox for clinical care
Primary Outcome Measures
NameTimeMethod
Change in caregiver-rated disease-specific symptomsBaseline to 12 months

Caregiver-reported ratings on disease-specific symptom rating scale. For example, Vanderbilt ADHD Parent Rating Scale for ADHD; Asthma Control Test for asthma

Secondary Outcome Measures
NameTimeMethod
Change in caregiver-rated global functioningBaseline to 12 months

Caregiver ratings on modified Clinical Global Assessment Scale

Experience of careBaseline and after every ambulatory visit for up to 84 months

Participant ratings on Post-Visit Experience of Care Survey

Number of patients with "red flag" alerts1 month

Number of patients whose responses to clinical questionnaires trigger a "red flag" alert in ICISS

Trial Locations

Locations (1)

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

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