Asthma
Conditions
Keywords
Asthma, Spirometry, Pediatric, Primary Health Care, Education, Distance
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.
Interventions
BEHAVIORALVirtually delivered spirometry quality improvement program
Sites in the intervention arm receive the virtually delivered QI program. The program includes: 1. Spirometry Fundamentals™ CD-ROM, a computer-based CD-ROM training program that teaches primary care providers and their staff techniques required to perform high-quality spirometry tests, and proper interpretation of spirometric data; 2. Case-based, interactive webinars; and 3. an Internet-based spirometry quality feedback reporting system.
Sponsors
University of Washington
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
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)
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spirometry test quality | Seven months | Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 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. |
| 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. |
Countries
United States
Outcome results
None listed