Trial of Spirometry Fundamentals™ in the Primary Care Setting
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      Spirometry is a recommended component of asthma diagnosis and treatment in the primary care
      setting, yet few primary care providers report routine use of spirometry in the provision of
      care for their asthma patients. Misclassification of asthma severity has been reported when
      assessment is based on symptoms alone. This misclassification can lead to inadequate
      treatment that may result in increased morbidity and increased healthcare utilization/cost.
      However, even when spirometry is utilized 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 the Spirometry Fundamentals™ tool
      in training primary care providers and their staff in producing high-quality flow-volume
      curves as compared to existing training modalities and to gather information in a
      'real-world' setting that can be used to improve Spirometry Fundamentals™.
    

Detailed description: 
      Currently few self-paced, distance learning programs exist that train staff to perform good
      quality spirometry tests. This study evaluates the effectiveness of a distance-learning tool
      for training primary care providers and their medical assistants in the use of spirometry to
      assist in managing obstructive lung disease (asthma and COPD). This tool is called
      "Spirometry Fundamentals™: A basic guide to lung function testing". It is a computer-based
      training program that teaches primary care providers and their staff what spirometry is, how
      it can be used, the techniques required to perform high-quality spirometry, and clinical
      interpretation of the spirometric data.

      We evaluated the effectiveness of Spirometry Fundamentals in the primary care setting by
      conducting a randomized controlled trial (RCT). Study participants were primary care
      physicians (MDs or DOs) and their staff (medical assistants (MAs) or nurses (RNs)) and were
      recruited as study pairs. The role of the MDs was to utilize spirometry in clinical care by
      ordering spirometry tests based on their clinical judgment, and the role of the MAs was to
      perform the spirometry. The patients performed the spirometry as part of their usual care
      were not considered study subjects.
    

Intervention name(s): Spirometry Fundamentals™ Training CD
Intervention type(s): Behavioral
Intervention description(s): MD-MA pairs randomized to the intervention arm of the study received 2 copies of the Spirometry Fundamentals™ CD. Included with the CDs was a letter explaining that each member of the MD-MA pair should view the CD at their convenience within the following 3 weeks. This letter included instructions on how to access the study website in order to complete an evaluation survey after viewing the CD.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Asthma; Spirometry; Pediatric; Primary Health Care; Education, Distance