- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01280500
Title: Comparative Effectiveness of Asthma Interventions Within an AHRQ PBRN
19. april 2022 oppdatert av: Wake Forest University Health Sciences
Accelerating Implementation of Comparative Effectiveness Findings on Clinical and Delivery Systems by Leveraging AHRQ Networks
The overall goal is to identify best practices for improving health outcomes for patients with asthma using comparative effectiveness research within an Agency for Healthcare Research and Quality (AHRQ) Practice-Based Research Network (PBRN).
This goal will be achieved by completing the following aims: (1) Create a centralized database for comparative effectiveness research on asthma by combining clinical and billing data from one of the largest healthcare systems in the country (Carolinas Healthcare System) with data from the school system, Medicaid, and patient and community-level datasets; (2) Deploy a fully developed integrated approach to asthma management based on the Chronic Care Model; (3) Develop and implement a "shared decision making" approach for asthmatic patients from disadvantaged backgrounds; (4) Implement an electronic data collection system for an existing CDC funded school-based asthma intervention that will allow program evaluation and link school nurses with providers; (5) Evaluate and compare the effectiveness of these three asthma management strategies on: overall healthcare consumption and medical costs; quality of life, school absenteeism and performance; asthma clinical measures; and medication utilization; and (6) Disseminate findings across the state via the statewide PBRN and other network partners.
This project has the potential to impact over 30,000 asthma patients across the Carolinas including many patients from disadvantaged backgrounds.
Studieoversikt
Status
Fullført
Forhold
Studietype
Intervensjonell
Registrering (Faktiske)
1040
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
North Carolina
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Charlotte, North Carolina, Forente stater, 28207
- Department of Family Medicine
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Charlotte, North Carolina, Forente stater, 28207
- CMC Elizabeth Family Medicine
-
-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Barn
- Voksen
- Eldre voksen
Tar imot friske frivillige
Ja
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
all with asthma diagnosis
Exclusion Criteria:
none
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Ikke-randomisert
- Intervensjonsmodell: Crossover-oppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Placebo komparator: Group A - Usual Care Controls
Group A will consist of 20 primary care clinics who are part of the Carolinas Healthcare System network but have not yet adopted the Electronic Medical Record System.
These practices do use the same billing databases as the remaining clinics, allowing easy identification of asthma patients and their health services utilization patterns.
Data from the billing systems will be used to retrospectively populate a database for these clinics from January 2009 forward.
|
No EMR
|
Aktiv komparator: Group B - EMR Control Practices
There are currently 65 primary care practices within the Carolinas Healthcare System network that have electronic medical record with decision support (EAP)access at baseline.
These practices will serve as a second level of control for comparison with the intervention groups.
Each of these practices is currently using Cerner PowerChart and at the start of the study and will have access to the asthma decision support tools; an electronically generated Asthma Action Plan (AAP); and a built-in system of population management reports which will be pushed to the practices on an on-going basis to help in patient recall and management.
The EAP approach to care has been developed with input from clinicians, hospital administrators, hospital information services personnel, and Cerner consultants.
|
Decision Support, Asthma Action Plans, and Population Management Reporting (EAP)
|
Aktiv komparator: C Integrated Approach to Care
There are 10 practices within the Carolinas Healthcare System (CHS) network that have already received additional training for improving outcomes for patients with chronic diseases termed the Integrated Approach to Care (IAC).
This IAC approach developed by CHS is based on the Chronic Care Model (CCM).
The IAC approach includes a heavy emphasis on the use of health information technology that practices receive during the initial EAP rollout.
|
Patients within the IAC group will also receive their own copy of an asthma action plan to allow for some degree of self-management support.
In addition, IAC practices receive assistance from a practice coach trained in practice redesign and rapid cycle process improvement.
|
Aktiv komparator: Group D - Shared Decision Making (SDM)
This approach has great potential for improved patient outcomes and provides an additional step in the successful implementation of patient self-management.
The research team will develop the SDM intervention during the first 6 months of the study.
In particular, the Shared decision making (SDM) intervention will be designed to be deployed within the 4 large clinics that care for the majority of the community's underserved and disadvantaged patients.
The SDM intervention development will be overseen by the study advisory board and actively recruit providers from within the clinics for feedback about the intervention.
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The research team will develop the SDM intervention during the first 6 months of the study.
The team will model this intervention on the randomized control trial performed by Dr. Sandra Wilson and colleagues within the Kaiser Permanente Clinics in California and Oregon
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Aktiv komparator: School Based Care (SBC)
Activities included: spending individual time with students to assess, treat, and monitor and to educate students in proper asthma management; facilitate access to health care and medicine; and communicate with parents.
|
the research team will start an electronic data capture system linking school data and the clinical EMR (Cerner Power Chart) that will be implemented over the first year.
Flow of data between schools and the hospital system will allow the children who have a regular source of care as well as those without a medical home to be treated with a unified asthma program by the school nurse and the hospital system.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Reducing Hospitalizations and Emergency Department Visits
Tidsramme: 2011-2013
|
Quality goals will be measured by the percentage of patients who reach the goal out of all patients identified with the disease through healthcare system data.
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2011-2013
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Improving Adherence to Medication
Tidsramme: 2011-2013
|
Quality goals will be measured by the percentage of patients who reach the goal out of all patients identified with the disease.
|
2011-2013
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Improve Quality of Life
Tidsramme: 2011-2013
|
Measured via Survey
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2011-2013
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Reduced School Absenteeism
Tidsramme: 2011-2013
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measured with school absenteeism data
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2011-2013
|
Improved Self-Efficacy
Tidsramme: 2011-2013
|
survey
|
2011-2013
|
Improved School Performance
Tidsramme: 2011-2013
|
measured by yearly end of grade results
|
2011-2013
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Michael F Dulin, MD, PhD, Wake Forest University Health Sciences
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. mars 2011
Primær fullføring (Faktiske)
1. august 2017
Studiet fullført (Faktiske)
1. august 2017
Datoer for studieregistrering
Først innsendt
19. januar 2011
Først innsendt som oppfylte QC-kriteriene
19. januar 2011
Først lagt ut (Anslag)
20. januar 2011
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
25. april 2022
Siste oppdatering sendt inn som oppfylte QC-kriteriene
19. april 2022
Sist bekreftet
1. februar 2018
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- HS10-014
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
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