Clinical trial NCT01161433: A Practical Model to Transform Childhood Asthma Care - Spirometry Training in the Primary Care Setting
Official title: Implementing Evidence-based Quality Improvement Strategies to Improve Asthma Care for Children
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Asthma
Keywords: Asthma
Spirometry
Pediatric
Primary Health Care
Education, Distance
Lead sponsor: University of Washington
Sponsor class: OTHER
First posted: 2010-07-13
Enrollment: 36
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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.

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 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

Primary outcomes:
measure: Spirometry test quality
timeFrame: Seven months
Secondary outcomes:
measure: Presence of asthma care plan
timeFrame: Seven months
measure: Asthma severity documentation
timeFrame: Seven months
measure: Appropriate prescription of controller therapy
timeFrame: Seven months
measure: Frequency of office-based spirometry
timeFrame: Seven months
Other outcomes:
Locations:
city: Seattle
country: United States
facility: University of Washington
state: Washington
Study officials:
affiliation: University of Washington
name: James W Stout, MD, MPH
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Washington/Seattle Children's Hospital
name: Rita Mangione-Smith, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: