A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting
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.
|Asthma||Behavioral: Virtually delivered spirometry quality improvement program|
|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|
- Spirometry test quality [ Time Frame: Seven months ]Percentage of acceptable quality spirometry tests as determined by standards set by the American Thoracic Society.
- Presence of asthma care plan [ Time Frame: 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.
- Asthma severity documentation [ Time Frame: Seven months ]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 ]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 ]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.
|Study Start Date:||October 2007|
|Study Completion Date:||September 2008|
|Primary Completion Date:||September 2008 (Final data collection date for primary outcome measure)|
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:
|No Intervention: Standard of Care|
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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01161433
|United States, Washington|
|University of Washington|
|Seattle, Washington, United States, 98195|
|Principal Investigator:||James W Stout, MD, MPH||University of Washington|
|Principal Investigator:||Rita Mangione-Smith, MD, MPH||University of Washington/Seattle Children's Hospital|