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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
The intervention is for a remote coach to assist patients with asthma for practices which will use Asthma module for guidance for asthma care.
The intervention is for practices to use the Asthma module for guidance for asthma care without assistance by a remote coach.
The practices will use the general CHADIS tool without access to the Asthma Module add-on to assist in asthma care.
Total Child Health
Baltimore, Maryland, United States
NHLBI recommended controller meds used
match between severity rating and NHLBI recommended med mgt
Time frame: 3-12 months
Emergency department visits
Self reported interval ED visits
Time frame: 3-12 months
Asthma trigger mitigation
self-reported efforts to reduce asthma triggers
Time frame: 3-12 months
Hospitalizations for asthma
Self reported hospitalizations
Time frame: 3-12 months
Steroid bursts
Self reported use of steroid bursts for asthma exacerbations
Time frame: 3-12 months
Influenza vaccine receipt
self reported receipt of flu vaccine for this season
Time frame: 3-12 months
asthma symptom control
severity/control ratings
Time frame: 3-12 months
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