Digital Action Plan for Asthma Exacerbations (PANAME)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 280
- 试验地点
- 2
- 主要终点
- Number of visits or unscheduled medical contacts
研究概览
简要总结
It is recommended that patients with asthma owned a written action plan which must include the names, doses and dosing of the treatment they should take when acute respiratory symptoms occur.
Current written action plans must be short to be readily used (1 page) and, therefore, cannot fit all acute situations. Moreover, they may not be available where and when required.
The investigators sought that a digital action plan, available through Smartphone or tablet computer connected to the internet, could adequately provide suitable action plans according to the severity of the described exacerbation, and would be more easily available when useful.
The aim of the study is to study the effect of the use of a digital action plan for asthma exacerbation, on the frequency of unscheduled medical contacts (phone calls, visits to physicians or to emergency departments, hospitalizations) in children and in adults with asthma. The investigators hypothesized that the use of the digital action plan could reduce avoidable unscheduled visits due to mild or moderate exacerbations that could successfully be managed by the patient or his/her caregivers.
详细描述
Asthma is a frequent chronic disease (10% prevalence in children and 7% in adults) during which acute exacerbations can occur that require adequate treatment, usually by the patients and/or his/her caregivers. Despite action plan for asthma exacerbation being recommended by national and international guidelines, urgent medical contact and often Emergency Department visits remain frequent for asthma exacerbation.
Reasons for medical contact may be related to the inefficiency of the current Written Action Plan because of its stereotyped advice whatever the level of severity of the exacerbation, and because the patients might not have the paper with him/her where and when he/she needs it.
The investigators sought that new electronic technologies could solve these issues of inadequacy of content and availability of the Written Action Plan.
A program was built to provide sets of advices according to the severity of the exacerbation described by the patient using simple clinical descriptors included in the Global Initiative for Asthma (GINA), and weighted by the medication already used for the exacerbation. In this way the investigators feel that patients could be more confident in the appropriate treatment proposed by the algorithm. Second, the possibility to connect through portable electronic devices (Smartphone, tablet computer) make the action readily available as far as an internet connection is possible.
The Digital Action Plan is designed to treat asthma exacerbations of all levels of severity and advice to visit a doctor within few days or to go at once to an emergency department as appropriate as by the situation based on the patients' information. The investigators designed a randomized study to assess the effect of the Digital Action Plan on unscheduled urgent medical contacts (phone calls, visits to physicians or to emergency departments, hospitalizations) in children and in adults with asthma.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 6 Years 至 60 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •children from 6 to 12 years or adults aged between 18 and 60 years
- •typical asthma with medical diagnosis
- •severe exacerbation (requiring ≥ 3 days of oral corticosteroids) during the previous 12 months
- •Internet connexion through a private (patient's or parents' patient's if child) smartphone and/or a tablet computer
- •no use of a written actin plan within the last 1 year
- •agreement to have phone calls or email contacts during the 1 year follow-up of the study
- •informed consent given, signed consent
- •affiliation to a social security
排除标准
- •atypical asthma: isolated cough, exercise respiratory discomfort
- •other respiratory disease (cystic fibrosis, COPD, etc.)
- •Severe heart disease (except high blood pressure)
- •smoking > 15 pack-years
- •asthma requiring regular oral corticosteroids treatment
- •asthma requiring inhaled controller treatment administered via nebulizations performed at home
- •no health insurance coverage
- •sister or brother already included in this study (applies only to children)
- •pregnancy and breastfeeding
研究组 & 干预措施
2: Digital action plan
Written action plan + Digital action plan for asthma exacerbations Digital action plan for asthma exacerbation available through an AppWeb and requiring a connected device such as a Smartphone or a tablet computer. The patient must connect and describe the situation to obtain the names, doses and dosing of the treatment his/her physician has recommended for him/her according to the level of severity of the exacerbation
干预措施: Digital action plan for asthma exacerbations + Written action plan (Other)
1: Written action plan
Written action plan
干预措施: Written action plan (Other)
结局指标
主要结局
Number of visits or unscheduled medical contacts
时间窗: during the 1 year follow-up
Frequency of urgent medical recourses (composite criterion): visits or unscheduled medical contacts + Emergency Departments visits or hospitalizations, in both arms of randomization
Emergency Departments visits or hospitalizations
时间窗: during the 1 year follow-up
Frequency of urgent medical recourses (composite criterion): visits or unscheduled medical contacts + Emergency Departments visits or hospitalizations, in both arms of randomization
次要结局
- number of school or working days missed(during the 1 year follow-up)
- number of scheduled medical(during the 1 year follow-up)
- Cumulative dose (in mg/kg) of oral corticosteroids during the 1 year follow-up(during the 1 year follow-up)
- assessment of the level of asthma control (GINA criteria) by a phone call(every 3 months, during the 1 year follow-up)
- number of unscheduled visits or medical contacts during the 1 year follow-up(during the 1 year follow-up)
- number of visits in Emergency Departments(during the 1 year follow-up)
- Adherence to the Digital Action Plan = number of moderate to severe exacerbations entered in the AppWeb with respect to all moderate to severe exacerbations reported(during the 1 year follow-up)
- Adherence to the Written Action Plan (number of times Written Action Plan was used with respect to all moderate to severe exacerbations)(during the 1 year follow-up)
- qualitative evaluation of the Digital Action Plan: descriptive study using a questionnaire filled out in the arm using the AppWeb(at 1 year)
- number of hospitalizations (>6 hours)(during the 1 year follow-up)