A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting
Implementing Evidence-based Quality Improvement Strategies to Improve Asthma Care for Children
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.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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:
- Spirometry Fundamentals™ CD-ROM;
- Case-based, interactive webinars; and
- an Internet-based spirometry quality feedback reporting system.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Washington
-
Seattle, Washington, États-Unis, 98195
- University of Washington
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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.
- Number of providers in practice (same number +/- 1 provider)
- Location - both practices must either be urban or rural
- % of patients eligible for Medicaid (same percentage +/- 15%)
- Practice type (school-based clinic, Federally Qualified Health Center, private practice, hospital- or university-based clinic)
- 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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Recherche sur les services de santé
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Aucune intervention: Norme de soins
|
|
|
Expérimental: Intervention
Virtually delivered spirometry quality improvement program
|
Sites in the intervention arm receive the virtually delivered QI program. The program includes:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Spirometry test quality
Délai: Seven months
|
Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.
|
Seven months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Presence of asthma care plan
Délai: 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.
|
Seven months
|
|
Asthma severity documentation
Délai: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which asthma severity is appropriately documented.
|
Seven months
|
|
Appropriate prescription of controller therapy
Délai: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which appropriate controller therapy is prescribed.
|
Seven months
|
|
Frequency of office-based spirometry
Délai: 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.
|
Seven months
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Rita Mangione-Smith, MD, MPH, University of Washington/Seattle Children's Hospital
- Chercheur principal: James W Stout, MD, MPH, University of Washington
Publications et liens utiles
Liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 32583-E/B
- HHSA290200600022, Task order 2 (Autre subvention/numéro de financement: Agency for Healthcare Research and Quality)
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