An interventional study of The implementation strategy to encourage the adoption of the Care Pathway in Asthma in Children and Implementation Science, sponsored by Basque Health Service. Recruiting at 1 site in Spain. Per ClinicalTrials.gov, last updated 2025-09-19.
Sponsored by Basque Health Service · Not applicable, Interventional, and Treatment
This study aims to evaluate the effect of the implementation of the new Asthma Integrated Care Pathway in the Basque Healthcare Service for the improvement of care for children with asthma attacks and the reduction of variability between professionals and care settings in this care practice. Asthma is the most common chronic disease in children and has a major impact on people's quality of life. The Asthma Integrated Care Pathway is a structured multidisciplinary care plan that details the essential steps in the care of patients with mild-moderate asthma attacks and the coordinated practice of the agents involved as dictated by the evidence. This pathway will include quality indicators of compliance with diagnostic criteria, assessment of severity and prescription of drugs, as well as the experience of families and professionals, which have been collected in meetings designed for this purpose.
The study consists in a mixed methods implementation trial with two phases:
The study will be carried out mainly in two integrated healthcare organizations (IHO), which are made up of two primary care areas and the paediatric reference hospital emergency department of both areas, as well as the hospitalisation, intensive care and paediatric pneumology departments of said hospital, to extend in the future the Asthma Integrated Care Pathway to the rest of the Basque Health Service IHOs.
Eligibility for professionals:
Eligibility for patients:
Patients between 2 and 14 years,that have being attended between the 7 May 2023 and the 7 May 2025, and with an acute episode of asthma, defined as:
All the primary care and hospital pediatricians of the two Integrated Hospital Organizations (IHO) (Barakaldo-Sestao and Ezkerraldea-Enkarterri-Cruces) where the care pathway will be implemented. 83 participants in total.
Behavioral: The implementation strategy to encourage the adoption of the Care Pathway
Primary care and hospital pediatricians of other IHOs where the care pathway is not implemented, but with similar characteristics to those in the experimental group, and with a proportion of 1:2. 166 participants in total.
1. Dissemination of the most novel aspects of the agreed Care Pathway via corporate mail. 2. Integration of information and communication tools into electronic health records to facilitate the recording and the standardized implementation of recommended practice. 3. Audit \& Feedback (A\&F) data reports, sent monthly, to each paediatrician on the rate of prescription of bronchodilators administered with a spacer chamber, together with the rates of the other indicators established in the pathway, in their health centre and in the rest of the centres in the participating health areas. 4. Interactive training sessions, in which epidemiological data and data on the health, economic and social impact of asthma attacks were presented, together with data on other indicators associated with the care pathway, and key messages on current treatment recommendations based on the latest clinical practice. 5. Distribution of reminder posters in paediatrics consultations, PEDs and health centers.
Percentage of bronchodilator treatment
The overall percentage of bronchodilator treatment with a spacer chamber in children diagnosed with mild-moderate asthma attacks.
Time frame: from baseline to 12 months, 24 months and 36 months
Pulmonary Score registration
Rate of Pulmonary Score registration in children diagnosed with mild-moderate asthma attacks, at all levels of care.
Time frame: from baseline to 12 months, 24 months and 36 months
Assessment and recording of persistent asthma symptoms.
Rate of assessment and recording of persistent asthma symptoms in children diagnosed with mild-moderate asthma attacks by ussing the PACT form (Pediatric Asthma Control Tool).
Time frame: from baseline to 12 months, 24 months and 36 months
Initiation of background treatment in children with persistent asthma symptoms
Rate of initiation of background treatment in children who have been assessed and registered with persistent asthma symptoms.
Time frame: from baseline to 12 months, 24 months and 36 months
Plan to share: Yes — Individual participant data will be shared that underlie results reported in the publication, after deidentification.
Supporting information: Study protocol
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Basque Health Service