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Completed

NCT Number: NCT01522144

An Electronic Decision Support Tool to Improve Outpatient Asthma Care

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.

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Key information

Conditions

Asthma Bronchial Diseases Hypersensitivity Hypersensitivity, Immediate Immune System Diseases Lung Diseases Lung Diseases, Obstructive Respiratory Hypersensitivity Respiratory Tract Diseases

Age range

1 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Children with the diagnosis of asthma
  • Children enrolled in one of 10 selected primary care practices in the PeRC practice-based research network

Treatment and study plan

Computerized Decision support

Behavioral

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.

Other names: electronic health record

Primary outcomes

  1. The proportion of patients on appropriate asthma controller medication at the end of the trial

    Time frame: assessed at each visit

    each patient who is classified as having persistant asthma should be on at least one appropriate controller medication for asthma.

Secondary outcomes

  1. 1) an updated asthma action plan

    Time frame: updated at least once per year

    Each patient should have an asthma care plan updated once per year

  2. 2)documentation of spirometry(6 to 18 yrs)in those with asthma

    Time frame: spirometry should be done once per year

    Each patient should have had spirometry at least once per year.

  3. 3) an updated problem list that reflects an assessment of asthma severity

    Time frame: tthe asthma severity should be on the problem list

    each patient should have their asthma severity classification on the thier chart

Sponsors and collaborators

Lead sponsor

Agency for Healthcare Research and Quality (AHRQ)

Fed

Collaborators

  • Children's Hospital of Philadelphia

Registry information

Official study title

EHR Decision Support to Improve Outpatient Asthma Care

Important dates

Study start
2006
Primary completion
2008
Study completion
2008
First posted
Jan 31, 2012
Registry last updated
Jan 31, 2012

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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