An Electronic Shared Decision-Making Application to Improve Asthma Outcomes

Study Overview
=================
Brief Summary
-----------------
This study will increase knowledge about the feasibility and effect on patient satisfaction and clinical outcomes of using an electronic Shared Decision Making (SDM) application (app) for patients with asthma in the allergy/immunology clinic visit setting. SDM is defined as an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options and make informed choices.

Official Title
-----------------
An Electronic Shared Decision-Making Application to Improve Asthma Outcomes

Conditions
-----------------
Asthma

Intervention / Treatment
-----------------
* Behavioral: Electronic Asthma Shared Decision-Making App
* Behavioral: Shared Decision Making Physician Training Video
* Behavioral: Electronic Asthma Shared Decision-Making App- Patient Data
* Behavioral: Standard Care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: English speaking Diagnosis of persistent asthma Have an in-person visit or telehealth encounter at the allergy/clinical immunology clinics participating in this study Exclusion Criteria: Diagnosis of intermittent asthma Any other lung disease Smoking greater than 20 pack years or current smoking Mental impairment such that participation would not be possible

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The subjects will be clustered in 2 groups of patients and physicians based on participating health care provider and clinic location. Group A will be the intervention group and Group B will be the control group.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A Patients who receive SDM intervention<br>Group A patients will complete a pre-visit electronic Asthma SDM App. They may also receive educational information regarding asthma, medication management, smoking cessation, COVID-19 and COVID-19 vaccines. | Behavioral: Electronic Asthma Shared Decision-Making App<br>* The electronic Asthma SDM App will ask questions related to medicine-related, non-medicine-related, and COVID-19-related concerns about patients' asthma, the patients' personal goals for asthma control and expectation for their upcoming visit, and the patients' preferred level of details and involvement in coming to a decision about their asthma treatment. They may also use the Asthma SDM app to find information about asthma, medication management, COVID-19 and COVID-19 vaccines.<br>|
| Active Comparator: Group B Patients who receive standard care<br>Group B patients will receive standard care. | Behavioral: Standard Care<br>* Standard Care for asthma.<br>|
| Experimental: Group A Physicians who receive SDM training and electronic Asthma SDM App data<br>Group A physicians will view an SDM Physician Training Video and receive the patients' reported data from the pre-visit asthma SDM App prior to the patients' visits. | Behavioral: Shared Decision Making Physician Training Video<br>* Training video to educate physicians on Shared Decision-Making and the use of Shared Decision-Making tools.<br>Behavioral: Electronic Asthma Shared Decision-Making App- Patient Data<br>* Data from the pre-visit electronic Asthma SDM app completed by the patients. Data includes medicine-related, non-medicine-related, and COVID-related concerns about patients' asthma, the patients' personal goals for asthma control and expectation for their upcoming visit, and the patients' preferred level of details and involvement in coming to a decision about their asthma treatment.<br>|
| Active Comparator: Group B Physicians who provide standard care<br>Group B physicians will provide standard care. | Behavioral: Standard Care<br>* Standard Care for asthma.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction | Patient satisfaction as determined by Patient Satisfaction Questionnaire responses. Questions will consist of the SDM-Q-9 (psychometrically validated measures for shared decision-making from the perspectives of patients), questions regarding satisfaction with content covered during the visit, and questions regarding satisfaction with the overall communication between the patient and physician. | Within 1 week of completing asthma shared decision making app worksheet and their asthma clinic visit | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physician satisfaction | Physician satisfaction as determined by Physician Satisfaction Questionnaire responses. Questions will consist of the SDM-Q-DOC (psychometrically validated measures for shared decision-making from the perspectives of health care providers), questions regarding satisfaction with content covered during the visit, and questions regarding satisfaction with the overall communication between the patient and physician. Physicians will receive a small number of satisfaction questionnaires, randomly assigned after patient visits, no more than one a week. | Within 1 week of patient visit | 
| Change in level of asthma control will be determined | Change in level of asthma control as determined by patient follow up asthma control test questionnaire responses regarding interval changes in asthma control, use of systemic steroids, and urgent care and emergency visits for asthma. | Up to 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Asthma, Shared Decision Making, SDM