A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting

Not Applicable

Completed

• Conditions: Asthma
• Interventions: Behavioral: Virtually delivered spirometry quality improvement program

• Registration Number: NCT01161433
• Lead Sponsor: University of Washington

Brief Summary

Spirometry is a recommended component of asthma diagnosis and treatment in the primary care setting, however, few primary care providers report routine use of spirometry in the provision of care for their asthma patients. Even when spirometry is used to aid in asthma severity classification, primary care providers have a high rate of failing to meet the quality goals for testing established by the American Thoracic Society.

The goal of this study is to evaluate the effectiveness of a virtually delivered quality improvement (QI) program. The program is designed to train primary care providers and their medical staff in the use of spirometry to improve pediatric primary care management for children with asthma.

Detailed Description

A cluster randomized trial with matched practice pairs. All practices receive a spirometer and standard vendor training. Those randomized to the intervention group receive a 7-month QI program, which includes:

1. Spirometry Fundamentals™ CD-ROM;

2. Case-based, interactive webinars; and

3. an Internet-based spirometry quality feedback reporting system.

Study Timeline

• Study Start: 2007-10
• Primary Completion: 2008-09
• Study Completion: 2008-09
• Study First Submitted: 2010-06-15
• Status Verified: 2010-07
• Study First Submitted QC: 2010-07-09
• Last Update Submitted: 2010-07-09
• Study First Posted: 2010-07-13
• Last Update Posted: 2010-07-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 36

Inclusion Criteria

• Internet access on a computer running Windows XP SP2

• Access to a computer with Windows 2000 /Mac OS 10 or higher

• Practices must match another enrolled practice on the following parameters.

  1. Number of providers in practice (same number +/- 1 provider)
  2. Location - both practices must either be urban or rural
  3. % of patients eligible for Medicaid (same percentage +/- 15%)
  4. Practice type (school-based clinic, Federally Qualified Health Center, private practice, hospital- or university-based clinic)
  5. Geographic distance (minimum of 10 miles away from matched pair practice)

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Exclusion Criteria

• Lack of Internet access on a computer running Windows XP SP2
• Lack of access to a computer with Windows 2000 /Mac OS 10 or higher
• Practices that were unable to be matched to another similar practice

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention	Virtually delivered spirometry quality improvement program	Virtually delivered spirometry quality improvement program

Primary Outcome Measures

Name	Time	Method
Spirometry test quality	Seven months	Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.

Secondary Outcome Measures

Name	Time	Method
Asthma severity documentation	Seven months	To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which asthma severity is appropriately documented.
Appropriate prescription of controller therapy	Seven months	To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which appropriate controller therapy is prescribed.
Frequency of office-based spirometry	Seven months	To test whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which office-based spirometry is used in the management of children with asthma.
Presence of asthma care plan	Seven months	To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which written asthma action plans are completed.

Trial Locations

Locations (1)

University of Washington; 🇺🇸 Seattle, Washington, United States