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The Electronic Asthma Action Plan System for Implementation in Primary Care

Information source: St. Michael's Hospital, Toronto
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Asthma

Intervention: Electronic Asthma Action Plan System (Other)

Phase: Phase 2

Status: Completed

Sponsored by: St. Michael's Hospital, Toronto

Summary

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. The investigators propose to develop and test a computerized tool that will 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. 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). We 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.

Clinical Details

Official title: The Electronic Asthma Action Plan System for Implementation in Primary Care

Study design: Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Primary outcome: The primary outcome will be the proportion of eligible patients to whom an AAP was delivered by the physician during the intervention period (52 weeks) compared to the baseline period (52 weeks).

Secondary outcome:

The impact of the eAAPS on patient-relevant outcomes including hospitalisations, ER visits, unscheduled & total visits to the doctor, days off work/school, nocturnal & daytime asthma symptoms, daytime rescue bronchodilator use, & quality of life

Proportion of all eligible patients who had asthma control documented

Proportion of eligible patients who had a medication change made

Proportion of eligible patients who had an appropriate medication change made (based on overall asthma control, when ascertainable)

Proportion of eligible patients to whom an AAP was delivered by the physician during the intervention period, when decision support was available (52 weeks), compared to the baseline period (52 weeks).

Eligibility

Minimum age: 16 Years. Maximum age: N/A. Gender(s): Both.

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.

Locations and Contacts

Wise Elephant Family Health Team, Brampton, Ontario L6X 1N3, Canada

McMaster Family Health Team, Hamilton, Ontario L8N 3Z6, Canada

St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada

Additional Information

Starting date: July 2012
Last updated: November 25, 2014

Page last updated: August 23, 2015

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