Clinical trial NCT03193242: The Electronic Asthma Management System
Official title: eAMS: The Electronic Asthma Management System
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Asthma
Keywords: Asthma
Asthma Action Plan
Lead sponsor: Unity Health Toronto
Sponsor class: OTHER
Collaborators: name: Ontario Lung Association
First posted: 2017-06-20
Enrollment: 50
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: This study is an extension of a pilot study in which investigators developed and tested a computerized tool to help physicians to determine if their patients' asthma is well controlled, advise them on medication changes required according to the current level of control, and automatically generate an electronic version of the AAP, all based on patient responses to a questionnaire completed by patients on a tablet computer. In this phase patients will have the ability to complete the questionnaire on their smartphones, through a pre-downloaded app and will have access to an electronic asthma self-management app.

Detailed description: Asthma is a common and potentially fatal chronic disease. An asthma action plan (AAP) is a written plan produced by a physician for a patient with asthma, to provide education and guidelines for self-management of worsening asthma symptoms. Studies have shown that AAPs effectively improve asthma control, but physicians fail to provide AAPs due to lack of time and adequate skills. Physicians also often fail to determine if their patients have good asthma control, and to adjust medications in response to patients' control level.

In a pilot study investigators developed and tested a computerized tool to help physicians to determine if their patients' asthma is well controlled, advise them on medication changes required according to the current level of control, and automatically generate an electronic version of the AAP, all based on patient responses to a questionnaire completed by patients on a tablet computer. In the pilot, investigators found that the tablet computers add a level of complexity to clinic flow. In this study patients will have the ability to complete the questionnaire on their smartphones, through a pre-downloaded app. Patients will also have access to an electronic asthma self-management tool called Breathe through which they can view their AAP and other asthma educational information.

The investigators hope that this system will eliminate the barriers that physicians face in determining asthma control, adjusting medications, and delivering an AAP, and will increase the frequency with which physicians are able to achieve these goals in patients with asthma. The objectives of the study are to determine the impact of this system on asthma action plan delivery by primary care physicians, the frequency of checking control level, and the frequency and appropriateness of asthma medication changes (in accordance with control). The investigators will also attempt to determine the impact of the system on hospitalisations, emergency room (ER) visits, unscheduled visits to the doctor, total visits to the doctor, days off work or school, nocturnal asthma symptoms, daytime asthma symptoms, daytime rescue puffer use, and quality of life, and to measure physicians' perceptions of and satisfaction with the system.

Eligibility criteria: Inclusion Criteria:

* Eligible physicians will include all primary care physicians at the 4 sites.
* Eligible patients will include:

patients with asthma, as determined by a validated electronic chart record search algorithm for asthma; patients \>/= 16 years of age.

Exclusion Criteria:

* Patients who received an AAP within the last 6 months (from their primary care physician, a respirologist, or any other source).
* Pregnant patients will be excluded given that conventional AAP recommendations may not be appropriate in this population.

Primary outcomes:
measure: Proportion of Received AAP
timeFrame: 12 Months
Secondary outcomes:
measure: Documented Asthma Control
timeFrame: 12 months
measure: Any Medication Change
timeFrame: 12 months
measure: Appropriate Medication Change
timeFrame: 12 months
measure: Healthcare utilization rate
timeFrame: 12 months
measure: Quality of life
timeFrame: 12 months
measure: Health Care Utilization
timeFrame: 12 months
measure: System Use
timeFrame: 12 months
measure: System usability
timeFrame: First 6 months of intervention
measure: Tool learnability
timeFrame: First 6 months of intervention
Other outcomes:
Locations:
city: Brampton
country: Canada
facility: Wise Elephant Family Health Team
state: Ontario
city: Toronto
country: Canada
facility: St. Michael's Hospital
state: Ontario
Study officials:
References: