Asthma
Conditions
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.
Interventions
BEHAVIORALRemote Coach plus Asthma Module
The intervention is for a remote coach to assist patients with asthma for practices which will use Asthma module for guidance for asthma care.
BEHAVIORALAsthma Module- No Coach
The intervention is for practices to use the Asthma module for guidance for asthma care without assistance by a remote coach.
BEHAVIORALCHADIS- no Asthma Module
The practices will use the general CHADIS tool without access to the Asthma Module add-on to assist in asthma care.
Sponsors
University of California, Los Angeles
Total Child Health, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 19 Years
Healthy volunteers
No
Inclusion criteria
* Asthma diagnosis
Exclusion criteria
* Not English or Spanish speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NHLBI recommended controller meds used | 3-12 months | match between severity rating and NHLBI recommended med mgt |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Asthma trigger mitigation | 3-12 months | self-reported efforts to reduce asthma triggers |
| Hospitalizations for asthma | 3-12 months | Self reported hospitalizations |
| 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 |
| asthma symptom control | 3-12 months | severity/control ratings |
| Steroid bursts | 3-12 months | Self reported use of steroid bursts for asthma exacerbations |
Countries
United States
Outcome results
None listed