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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Washington
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Seattle, Washington, Verenigde Staten, 98195
- University of Washington
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Onderzoek naar gezondheidsdiensten
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Geen tussenkomst: Zorgstandaard
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Experimenteel: Intervention
Virtually delivered spirometry quality improvement program
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Sites in the intervention arm receive the virtually delivered QI program. The program includes:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Spirometry test quality
Tijdsspanne: Seven months
|
Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.
|
Seven months
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Presence of asthma care plan
Tijdsspanne: 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.
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Seven months
|
|
Asthma severity documentation
Tijdsspanne: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which asthma severity is appropriately documented.
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Seven months
|
|
Appropriate prescription of controller therapy
Tijdsspanne: Seven months
|
To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which appropriate controller therapy is prescribed.
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Seven months
|
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Frequency of office-based spirometry
Tijdsspanne: 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
|
Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Rita Mangione-Smith, MD, MPH, University of Washington/Seattle Children's Hospital
- Hoofdonderzoeker: James W Stout, MD, MPH, University of Washington
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 32583-E/B
- HHSA290200600022, Task order 2 (Ander subsidie-/financieringsnummer: Agency for Healthcare Research and Quality)
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