An interventional study of Computerized Decision support in Asthma, sponsored by Agency for Healthcare Research and Quality (AHRQ). Completed at 1 site in United States. Open to participants aged 1 Year to 18 Years. Per ClinicalTrials.gov, last updated 2012-01-31.
Sponsored by Agency for Healthcare Research and Quality (AHRQ) · Not applicable and Interventional
The Children's Hospital of Philadelphia's ambulatory network uses an electronic health record (EHR) to document clinical information. Using the EHR, a clinical decision support tool will be designed to help the primary care physician's in caring for children with asthma. The goal will be to improve the primary care physician's use of the national Institutes of Health guidelines for the best care for asthma. To study this EHR decision support tool, it will be introduced into 5 practices while 5 other practices will have the existing asthma care information. It will be determined whether the physicians in the practices with the decision support tool are better at following the asthma guidelines. If the decision support tool works...then it will be offered to others to use with their EHR systems.
National Asthma Education and Prevention Program guidelines (NAEPP) exist, but are under used in Primary Care. In addition, implementation of the guidelines has been shown to be vary according to the location of practice and other contextual factors.
The Children's Hospital of Philadelphia Pediatric Research Consortium (PeRC), a practice-based research network will determine whether an innovative clinical decision support system embedded in an existing electronic health record (EHR) will improve provider adherence to the existing NAEPP guidelines.
After receiving a standardized education module based on NAEPP guidelines, 10 primary care pediatric practices (both urban and suburban) will be randomized to receive either a passive EHR (control sites) or an interactive decision support sytem (intervention sites).
The primary outcome of interest will be the proportion of patient son appropriate asthma controller medication compared over time. Secondary outcomes include the proportion of asthma patients with: 1) an updated asthma action plan 2) documentation of spirometry performed (6 to 17years) and 3) an updated problem list reflecting current asthma severity. After hours calls to providers and types of office visits related to to asthma will be tracked. Contextual factors at the clinic and patient level will be examined to assess their association with the outcomes of interest. In addition, measurement of asthma-related quality of life and missed school and work in a sample of 200 subjects from each group will be performed
If shown to be successful, this type of clinical decision support, embedded within the EHR, has the potential to be a powerful tool to improve the implementation of asthma guidelines and clinical practice guidelines for other conditions and illnesses.
3,921 studies on the registry are indexed under Asthma; 507 are open to participants now.
This study's enrollment of 1,030 is above the median of 83 across 2,752 interventional studies indexed under Asthma.
Browse Asthma studies →Agency for Healthcare Research and Quality (AHRQ) is the lead sponsor of 32 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
Inclusion Criteria:
decision support compared to no decision support in a cluster-randomized trial by practise
Behavioral: Computerized Decision support
Using a clustered randomized method, computerized decision support, embedded in the electronic health record, was offered to selected primary care practices and outcomes of asthma care were compared to those practices without the computerized decision support.
Also known as: electronic health record
The proportion of patients on appropriate asthma controller medication at the end of the trial
each patient who is classified as having persistant asthma should be on at least one appropriate controller medication for asthma.
Time frame: assessed at each visit
1) an updated asthma action plan
Each patient should have an asthma care plan updated once per year
Time frame: updated at least once per year
2)documentation of spirometry(6 to 18 yrs)in those with asthma
Each patient should have had spirometry at least once per year.
Time frame: spirometry should be done once per year
3) an updated problem list that reflects an assessment of asthma severity
each patient should have their asthma severity classification on the thier chart
Time frame: tthe asthma severity should be on the problem list
This study is completed, as verified in Jan 2012. You cannot join it, but the record below documents what was studied.
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Agency for Healthcare Research and Quality (AHRQ)