Evaluation of a Mobile Application to Facilitate the Interpretation of Spirometry by Family Physicians and Residents

Evaluation of a Mobile Application to Facilitate the Interpretation of the Spirometry Test by Family Physicians and Family Medicine Residents: Impact on Prescription and Interpretation of This Test

Problematic: Spirometry is used to objectify the obstructive syndrome defining chronic obstructive pulmonary disease (COPD). However, this test remains underused in the primary care. The tools available for its interpretation are little used and the existence of several decision algorithms can create confusion during the diagnosis.

Principal objective: To evaluate the impact of a mobile application (SPIRO©) on medical practice (interpretation and prescription of spirometry) of family physicians and family medicine residents working in family medicine units (FMU) in Quebec affiliated with Laval University.

Secondary objective : To evaluate the usability of SPIRO© among family physicians and residents in family medicine working in FMU in Quebec affiliated with Laval University.

Methods: This is a pre-post clinical trial with control group. Participants (family MD and family medicine residents) will be recruited from the various FMU affiliated with Laval University. Participants working in the FMU in the experimental group will be able to use the SPIRO® mobile application to facilitate interpretation of the spirometry test results while participants in the control group will not have access to it during the study. The basic characteristics of the participants and various behavioral parameters based on the theory of planned behavior concerning the interpretation and prescription of spirometry test will be measured. Data from the control group will be collected before those in the experimental group at the time the application is not yet available, which will minimize contamination between groups. The data will be collected with questionnaires delivered in person to the participants before the intervention (T0 time) and then four months later (T1 time) during their team or research meeting. Participants will be recruited in eight of the 12 Quebec FMU affiliated with Laval University, who will be randomly assigned to two equal groups: control and experimental. The intervention will consist in sending the SPIRO© mobile application to participants in the experimental group who will use it for a period of four months.

Study Overview

• Status: Completed
• Conditions: COPD; Spirometry; Mobile Application
• Intervention / Treatment: Device: SPIRO

Detailed Description

Hypothesis : The investigators hypothesize that the use of the SPIRO© application will increase the skills and confidence of family physicians and family medicine residents in prescribing and interpreting spirometry compared to the control group.

The project will be conducted in the following six major steps: 1) Collection of socio-demographic and behavioral characteristics of participants using sections A, B, C and D of the NAPI questionnaire in the control group; 2) Intervention in the control group (they will continue their daily medical practice without being subject to any intervention by our research team), for a period of 4 months; 3) Measurement of behavioral changes in the control group using Sections B, C, D and E of the NAPI questionnaire 4 months after the start of the study; 4) Collection of socio-demographic and behavioral data from participants in the experimental group using sections A, B, C and D of the NAPI questionnaire; 5) E-mail distribution of the application and use of the application by participants in the experimental group for a period of four months, 6) Measurement of behavioral changes in the experimental group after the use of the application, Using sections B, C, D and E of the NAPI questionnaire as well as a questionnaire on the application SPIRO© (SPIRO questionnaire) which will evaluate the usability of this one.

The study has been approved by the research ethic board of the Health and Social Services Center of the old capital - attached to the Integrated Center for Health and Social Services of the National Capital.

• Study Type: Observational
• Enrollment (Actual): 104

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Baie-Comeau, Quebec, Canada, G4Z 3B8
      • UMF de Manicouagan
    • Gaspé, Quebec, Canada, G4X 2W2
      • UMF de Gaspé
    • Lac-Etchemin, Quebec, Canada, G0R 1S0
      • UMF des Etchemins
    • Lévis, Quebec, Canada, G6W 0J4
      • UMF de Lévis
    • Quebec City, Quebec, Canada, G1J 2G1
      • Unité de médecine familiale - GMF Maizerets
    • Quebec City, Quebec, Canada, G1L 3L5
      • UMF Saint-François d'Assise
    • Quebec City, Quebec, Canada, G1V 0B7
      • Unité de médecine familiale Laval
    • Trois-Pistoles, Quebec, Canada, G0L 4K0
      • UMF de Trois-Pistoles

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Primary care physicians and residents in family medicine of 18 years old or more working in one of the 12 family medicine units in Quebec affiliated with Laval University.

Description

Inclusion Criteria:

• Participants need to be primary care physicians or residents in family medicine of 18 years old or more working in one of the 12 family medicine units in Quebec affiliated with Laval University.

Exclusion Criteria:

• Health professionals not practicing family medicine and residents of other specialties will not be eligible. Individuals who participated in the development of the " subjective Norms, Attitudes, Perceived behavioral control, Intentions (NAPI) " questionnaires (apparent validation) will be excluded.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Control Group; Primary care physicians and residents in family medicine of family medicine units affiliated with Laval University.
Experimental Group; Primary care physicians and residents in family medicine of family medicine units affiliated with Laval University that will use the mobile application SPIRO(c) for a period of four months.	Device: SPIRO; Participants in the Experimental Group will be asked to use SPIRO mobile application during a period of 4 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Beliefs about capabilities - interpretation	The beliefs about the capabilities of primary care physicians and residents in family medicine regarding interpretation of spirometry.	six weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Beliefs about consequences - prescription	The beliefs about the consequences of primary care physicians and residents in family medicine regarding prescription of spirometry.	six weeks
Beliefs about consequences - interpretation	The beliefs about the consequences of primary care physicians and residents in family medicine regarding interpretation of spirometry.	six weeks
Beliefs about consequences - use of a mobile application	The beliefs about the consequences of primary care physicians and residents in family medicine regarding the use of a mobile application to interpret spirometry.	six weeks
Moral norms - prescription	The beliefs about the moral norms of primary care physicians and residents in family medicine regarding prescription of spirometry.	six weeks
Moral norms - interpretation	The beliefs about the moral norms of primary care physicians and residents in family medicine regarding interpretation of spirometry.	six weeks
Moral norms - use of a mobile application	The beliefs about the moral norms of primary care physicians and residents in family medicine regarding the use of a mobile application to interpret spirometry.	six weeks
Intentions - prescription	The beliefs about the intentions of primary care physicians and residents in family medicine regarding prescription of spirometry.	six weeks
Intentions - interpretation	The beliefs about the intentions of primary care physicians and residents in family medicine regarding interpretation of spirometry.	six weeks
Intentions - use of a mobile application	The beliefs about the intentions of primary care physicians and residents in family medicine regarding the use of a mobile application to interpret spirometry.	six weeks
Social influence - prescription	The beliefs about the social influence of primary care physicians and residents in family medicine regarding prescription of spirometry.	six weeks
Social influence - interpretation	The beliefs about the social influence of primary care physicians and residents in family medicine regarding interpretation of spirometry.	six weeks
Social influence - use of a mobile application	The beliefs about the social influence of primary care physicians and residents in family medicine regarding the use of a mobile application to interpret spirometry.	six weeks
Belief about capabilities - prescription	The beliefs about the belief about capabilities of primary care physicians and residents in family medicine regarding prescription of spirometry.	six weeks
Belief about capabilities - use of a mobile application	The beliefs about the belief about capabilities of primary care physicians and residents in family medicine regarding the use of a mobile application to interpret spirometry.	six weeks

Collaborators and Investigators

• Sponsor: Laval University
• Investigators: Principal Investigator: Louis-Philippe Boulet, MD, Heart and Lung Institute

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2016
• Primary Completion (Actual): July 7, 2017
• Study Completion (Actual): December 20, 2017

Study Registration Dates

• First Submitted: June 26, 2017
• First Submitted That Met QC Criteria: June 29, 2017
• First Posted (Actual): July 2, 2017

Study Record Updates

• Last Update Posted (Actual): October 12, 2020
• Last Update Submitted That Met QC Criteria: October 8, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: COPD; Spirometry; Mobile application
• Other Study ID Numbers: SPIRO-MD Residents

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No