Web System for Engaging Families & Doctors in Continuous Asthma Quality Improvement

Total Child Health, Inc.

Status: Withdrawn

Conditions: Asthma

Treatments: Behavioral: CHADIS- no Asthma Module; Behavioral: Remote Coach plus Asthma Module; Behavioral: Asthma Module- No Coach

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT02435394

1R44HL117482

Details and patient eligibility

About

Asthma, one of the most common pediatric illnesses, is optimally managed according to National Heart Lung and Blood Institute (NHLBI) guidelines yet this is not often done in primary care. This project is to develop and test the effects of using a module for guideline based care in the Child Health and Development Interactive System (CHADIS) online system by prompting and incorporating patient symptom/control and adherence data from standard questionnaires to inform visits and providing automated patient specific education and Asthma Action Plans in individual Care Portals.

Full description

We will complete the formative work collecting professional opinion to create and pilot the initial CHADIS Asthma Intervention module (CHADIS-AI), an innovative decision support system. CHADIS-AI content will be assembled and vetted by asthma experts and primary care providers (PCPs). Parent and teen focus groups will vet the content and language of the adherence materials and Care Portal. A system will also be established for points for patient participation, to give clinicians Maintenance of Certification (MOC) credit, and ongoing run chart reports of their patients' asthma status for continual Quality Improvement (QI) feedback. The resulting system will be pilot tested and refined by clinician feedback. Practices will be randomly assigned to intervention vs control. Control practices will use CHADIS for asthma care without the A-I module. Intervention practices will be further randomized to have remote coach support for patients or not. Outcomes will be examined of asthma severity/control, match of severity with guideline based medication management, numbers of Emergency Department (ED) visits, hospitalizations and oral steroid use. Effect of remote coaching will also be assessed.

Sex: All

Ages: Under 19 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Asthma diagnosis

Exclusion criteria

• Not English or Spanish speaking

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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0 participants in 3 patient groups

Remote Coach plus Asthma Module

Experimental group

Description:

The intervention is for practices to have remote coach support for patients with asthma in addition to doctors using CHADIS-Asthma module. Practices will start sequentially for a time series analysis.

Treatment:

Behavioral: Remote Coach plus Asthma Module

Asthma Module- No Coach

Experimental group

Description:

The intervention is for practices to use CHADIS-Asthma module to improve patient care without a remote coach assisting patient adherence.

Treatment:

Behavioral: Asthma Module- No Coach

CHADIS- no Asthma module

Active Comparator group

Description:

Practices using CHADIS but no Asthma module as a control condition.

Treatment:

Behavioral: CHADIS- no Asthma Module