PackHealth: Asthma Engagement Tool

Not Applicable

Completed

Brief Summary: The purpose of this study is to test the impact of an innovative patient engagement solution on patient's quality of life and asthma-related outcomes, and evaluate the correlation between a patient reported outcome measure and clinical outcomes.

Detailed Description: Patient engagement is a critical part of improving patient care and outcomes. Current patient engagement strategies only focus on the patient-physician interaction and have been shown to be ineffective.

The need for a comprehensive approach to patient engagement is no different among patients with asthma as it is in any other chronic condition. Patients with asthma must make complicated health decisions daily that impact their social and occupational activities, quality of life, and treatment adherence. Obtaining, communicating, processing, and understanding non- biased health information are crucial in making appropriate and informed treatment decisions.

Pack Health LLC and Duke will develop a patient engagement toolkit known as "Packs" to help empower and engage patients. These disease-specific, evidence-based kits are scientifically designed to improve patient involvement in their own care. Each Pack draws on the science of change management and patient activation and contains three categories of materials

Recruitment & Eligibility

Inclusion Criteria

Patients with a physician diagnosis of asthma for at least the previous 12 months.
Asthma that is not well controlled by NAEPP guidelines.
Ability and willingness to provide informed consent

Exclusion Criteria

Significant alcohol consumption of more than three alcoholic drinks per day or active substance abuse.
Chronic disease (other than asthma) that in the opinion of the investigator would prevent participation in the trial or put the participant at risk by participation e.g. chronic diseases of the lung (other than asthma), heart, liver, kidney, endocrine or nervous system or immunodeficiency that are not well addressed or controlled.
A diagnosis of cancer with ongoing treatment.
Any terminal illness or conditions that results in a life expectancy less than one year.

Arm && Interventions

Group	Intervention	Description
Asthma Patients	Patient engagement toolkit	Patient engagement toolkit

Primary Outcome Measures

Name	Time	Method
Rate of Asthma Exacerbations	baseline to week 13	The average number of asthma events requiring treatment with oral corticosteroids, emergency room visits or hospitalizations from baseline to week 13

Secondary Outcome Measures

Name	Time	Method
Change in Asthma Control	baseline, 13 weeks	Measured by the Asthma Control Test (ACT), patient self-administered tool for identifying those with poorly controlled asthma. The ACT assesses the frequency of dyspnea and general asthma symptoms, use of rescue medications, the effect of asthma on daily functioning, and overall self-assessment of asthma control. 5 items with 4-week recall. The score range is 5-25 with \>19 representing good control and \<18 representing poor control.
Change in Pulmonary Function Tests	baseline, 13 weeks	Measured by spirometry. We measured forced expiratory volume in one second (FEV1) and forced vital capacity both in liters. FEV1 is a measure of airflow obstruction. The change in lung function is the change in these measurements compared to baseline.
Number of Emergency Department and Hospitalization Visits	13 weeks	Number of emergency department and hospitalization visits will be recorded
Change in Asthma Symptoms	baseline, 13 weeks	Measured by asthma symptom utility index (ASUI). The Asthma Symptom utility Index (ASUI) is a brief, interviewer-administered, patient preference-based scale assessing frequency and severity of asthma-related symptoms and treatment side effects. Number of items 11 items with 2 week recall. Scores range from 0 (worst possible symptoms) to 1 (no symptoms) Minimal Clinically Important Difference (MCID) \> 0.09