Clinical trial NCT01168635: Improving Asthma Outcomes Through Spirometry Distance Learning
Official title: Improving Asthma Outcomes Through Spirometry Distance Learning
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Asthma
Keywords: Asthma
Spirometry
Pediatric
Primary Health Care
Education, Distance
Lead sponsor: Seattle Children's Hospital
Sponsor class: OTHER
Collaborators: name: University of Washington
name: Boston University
First posted: 2010-07-23
Enrollment: 660
Sex: ALL
Minimum age (years): 5
Maximum age (years): 17
Standard ages: CHILD
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, yet few providers report its routine use for children with asthma. Misclassification of asthma severity occurs when assessment is based on symptoms alone. This misclassification can lead to inadequate treatment, increased morbidity, and increased healthcare utilization/cost.

The goal of this study is to test the effectiveness of a distance learning quality improvement program called Spirometry 360 developed by the interactive Medical Training Resources (iMTR) group at the University of Washington Child Health Institute. The Spirometry 360 program aims to improve care for children with asthma by enhancing provider knowledge and self-efficacy related to the use and interpretation of office-based spirometry.

Detailed description: The Spirometry 360 program includes:

1. "Spirometry Fundamentals™: A basic guide to lung function testing," a computer-based training program that teaches primary care providers how to coach patients to produce high-quality spirometry tests and accurately interpret spirometric data;
2. Spirometry Learning Lab: Case-based teaching of spirometry in practice guides test administrators and interpreters through clinical examples in an interactive virtual classroom setting. These sessions are led by expert clinical faculty and are archived for future reference and review;
3. Spirometry Feedback: Tailored analysis of providers' spirometry testing sessions offers monthly individualized feedback reports by clinical experts on spirometry tests performed in the clinic.

This is a cluster randomized controlled trial to test the effectiveness of the Spirometry 360 program. The Spirometry 360 program will be provided to 25 primary care pediatric practices from two practice-based research networks. A separate group of 25 matched control practices recruited from these same networks will receive standard training from the equipment vendor during the study and the Spirometry 360 training program at the end of the study.

Eligibility criteria: Inclusion Criteria (Parent):

* Parents must have a child who has had at least one visit for asthma with a participating provider during the 12 months before the study start date
* Must have monthly access to email and the Internet
* Must have child aged 5-16 years

Inclusion Criteria (Child):

* Aged 5-16 years
* Must have access to email and the Internet

Exclusion Criteria (Parents):

* Parents with children who are outside our target age range of 5-16 years old
* Parents with children who haven't had a clinic visit for asthma care in the last year
* Parents without monthly access to the Internet

Exclusion Criteria (Child):

* Children who are outside our target age range of 5-16 years
* Children without monthly access to email and the Internet

Primary outcomes:
measure: Healthcare utilization
timeFrame: Assessed monthly for 1 year
measure: Cost of asthma care
timeFrame: Every 6 months
measure: Asthma-specific health-related quality of life
timeFrame: Every 6 months
Secondary outcomes:
measure: Acceptable spirometry testing sessions
timeFrame: Assessed monthly for 1 year
measure: Appropriate prescription of controller therapy
timeFrame: Assessed monthly for 1 year
Other outcomes:
Locations:
city: Boston
country: United States
facility: Slone Center Office-based Research Network (SCOR) - Boston University
state: Massachusetts
city: Seattle
country: United States
facility: Seattle Children's Hospital Research Institute
state: Washington
city: Seattle
country: United States
facility: Child Health Institute - Unversity of Washington
state: Washington
city: Seattle
country: United States
facility: Puget Sound Pediatric Research Network
state: Washington
Study officials:
affiliation: Seattle Children's Hospital/University of Washington
name: Rita Mangione-Smith, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: