Web System for Engaging Families & Doctors in Continuous Asthma Quality Improvement
- Conditions
- Asthma
- Interventions
- Behavioral: Remote Coach plus Asthma ModuleBehavioral: CHADIS- no Asthma ModuleBehavioral: Asthma Module- No Coach
- Registration Number
- NCT02435394
- Lead Sponsor
- Total Child Health, Inc.
- Brief Summary
Asthma, one of the most common pediatric illnesses, is optimally managed according to National Heart Lung and Blood Institute (NHLBI) guidelines yet this is not often done in primary care. This project is to develop and test the effects of using a module for guideline based care in the Child Health and Development Interactive System (CHADIS) online system by prompting and incorporating patient symptom/control and adherence data from standard questionnaires to inform visits and providing automated patient specific education and Asthma Action Plans in individual Care Portals.
- Detailed Description
We will complete the formative work collecting professional opinion to create and pilot the initial CHADIS Asthma Intervention module (CHADIS-AI), an innovative decision support system. CHADIS-AI content will be assembled and vetted by asthma experts and primary care providers (PCPs). Parent and teen focus groups will vet the content and language of the adherence materials and Care Portal. A system will also be established for points for patient participation, to give clinicians Maintenance of Certification (MOC) credit, and ongoing run chart reports of their patients' asthma status for continual Quality Improvement (QI) feedback. The resulting system will be pilot tested and refined by clinician feedback. Practices will be randomly assigned to intervention vs control. Control practices will use CHADIS for asthma care without the A-I module. Intervention practices will be further randomized to have remote coach support for patients or not. Outcomes will be examined of asthma severity/control, match of severity with guideline based medication management, numbers of Emergency Department (ED) visits, hospitalizations and oral steroid use. Effect of remote coaching will also be assessed.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- Not specified
- Asthma diagnosis
- Not English or Spanish speaking
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Remote Coach plus Asthma Module Remote Coach plus Asthma Module The intervention is for practices to have remote coach support for patients with asthma in addition to doctors using CHADIS-Asthma module. Practices will start sequentially for a time series analysis. CHADIS- no Asthma module CHADIS- no Asthma Module Practices using CHADIS but no Asthma module as a control condition. Asthma Module- No Coach Asthma Module- No Coach The intervention is for practices to use CHADIS-Asthma module to improve patient care without a remote coach assisting patient adherence.
- Primary Outcome Measures
Name Time Method NHLBI recommended controller meds used 3-12 months match between severity rating and NHLBI recommended med mgt
- Secondary Outcome Measures
Name Time Method Emergency department visits 3-12 months Self reported interval ED visits
Influenza vaccine receipt 3-12 months self reported receipt of flu vaccine for this season
Hospitalizations for asthma 3-12 months Self reported hospitalizations
Steroid bursts 3-12 months Self reported use of steroid bursts for asthma exacerbations
Asthma trigger mitigation 3-12 months self-reported efforts to reduce asthma triggers
asthma symptom control 3-12 months severity/control ratings
Trial Locations
- Locations (1)
Total Child Health
🇺🇸Baltimore, Maryland, United States