A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting

This study has been completed.
Sponsor:
Information provided by:
University of Washington
ClinicalTrials.gov Identifier:
NCT01161433
First received: June 15, 2010
Last updated: July 9, 2010
Last verified: July 2010
  Purpose

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.


Condition Intervention
Asthma
Behavioral: Virtually delivered spirometry quality improvement program

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Implementing Evidence-based Quality Improvement Strategies to Improve Asthma Care for Children

Resource links provided by NLM:


Further study details as provided by University of Washington:

Primary Outcome Measures:
  • Spirometry test quality [ Time Frame: Seven months ] [ Designated as safety issue: No ]
    Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.


Secondary Outcome Measures:
  • Presence of asthma care plan [ Time Frame: Seven months ] [ Designated as safety issue: No ]
    To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which written asthma action plans are completed.

  • Asthma severity documentation [ Time Frame: Seven months ] [ Designated as safety issue: No ]
    To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which asthma severity is appropriately documented.

  • Appropriate prescription of controller therapy [ Time Frame: Seven months ] [ Designated as safety issue: No ]
    To assess whether exposure to the virtually delivered quality improvement (QI) program increases the frequency with which appropriate controller therapy is prescribed.

  • Frequency of office-based spirometry [ Time Frame: Seven months ] [ Designated as safety issue: No ]
    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.


Enrollment: 36
Study Start Date: October 2007
Study Completion Date: September 2008
Primary Completion Date: September 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Intervention
Virtually delivered spirometry quality improvement program
Behavioral: Virtually delivered spirometry quality improvement program

Sites in the intervention arm receive the virtually delivered QI program.

The program includes:

  1. Spirometry Fundamentals™ CD-ROM, a computer-based CD-ROM training program that teaches primary care providers and their staff techniques required to perform high-quality spirometry tests, and proper interpretation of spirometric data;
  2. Case-based, interactive webinars; and
  3. an Internet-based spirometry quality feedback reporting system.
No Intervention: Standard of Care

Detailed Description:

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:

  1. Spirometry Fundamentals™ CD-ROM;
  2. Case-based, interactive webinars; and
  3. an Internet-based spirometry quality feedback reporting system.
  Eligibility

Ages Eligible for Study:   18 Years to 90 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

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.

    1. Number of providers in practice (same number +/- 1 provider)
    2. Location - both practices must either be urban or rural
    3. % of patients eligible for Medicaid (same percentage +/- 15%)
    4. Practice type (school-based clinic, Federally Qualified Health Center, private practice, hospital- or university-based clinic)
    5. 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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01161433

Locations
United States, Washington
University of Washington
Seattle, Washington, United States, 98195
Sponsors and Collaborators
University of Washington
Investigators
Principal Investigator: James W Stout, MD, MPH University of Washington
Principal Investigator: Rita Mangione-Smith, MD, MPH University of Washington/Seattle Children's Hospital
  More Information

No publications provided

Responsible Party: James W. Stout/Principal Investigator, University of Washington
ClinicalTrials.gov Identifier: NCT01161433     History of Changes
Other Study ID Numbers: 32583-E/B, HHSA290200600022, Task order 2
Study First Received: June 15, 2010
Last Updated: July 9, 2010
Health Authority: United States: Federal Government
United States: Institutional Review Board

Keywords provided by University of Washington:
Asthma
Spirometry
Pediatric
Primary Health Care
Education, Distance

Additional relevant MeSH terms:
Asthma
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases

ClinicalTrials.gov processed this record on August 20, 2014