RANDOMIZED TRIAL--COMPUTERIZED ASTHMA MANAGEMENT SYSTEM

随机试验--计算机化哮喘管理系统

• 批准号: 6638839
• 负责人: PAULA LOZANO
• 金额: $ 46.16万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-06 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6638839
• 关键词: asthma; child (0-11); clinical trials; computer assisted patient care; cost effectiveness; health care quality; human subject; human therapy evaluation; interview; patient care management; patient oriented research; pediatrics; primary care physician; respiratory disease /disorder therapy

Practice variation is widespread in pediatric care. Asthma has been the target of many quality improvement efforts. However, most attempts have been costly or hampered by the challenges of changing provider behavior. This randomized controlled trial aims to test the ability of a real-time computerized intervention to improve care for children with asthma in a cost-effective manner. The computerized asthma management system (CAMS) aims to change primary care providers' prescribing behavior and chronic disease management by delivering evidence-based guidelines and asthma management tools at the point of care. CAMS differs from other asthma interventions in three ways. First, it preserves clinician autonomy. Second, recommendations are driven by patient-specific data. Third, CAMS is easier to use than to ignore. Because it is automated, it involves potentially much lower costs than other quality improvement efforts. We will randomize providers in three diverse pediatric clinics to CAMS or usual care. We hypothesize that CAMS will result in improved care among providers randomized to receive it. Specifically, we hypothesize that CAMS providers will be more likely to prescribe controller medication when appropriate and to prepare written asthma care plans; and that children with asthma receiving care from CAMS providers will experience fewer symptom days. We further hypothesize that CAMS will result in no net cost increases to providers. We will assess the effectiveness of CAMS by prospectively collecting data on medication use, home care, symptom days, health status, utilization and satisfaction from computerized data and telephone interviews of 750 patients/parents.

儿科护理中的实践变化很普遍。哮喘一直是许多质量改进工作的目标。然而，大多数尝试成本高昂，或者因改变提供商行为的挑战而受到阻碍。 这项随机对照试验旨在测试实时计算机干预以经济高效的方式改善哮喘儿童护理的能力。 计算机化哮喘管理系统（CAMS）旨在通过在护理点提供循证指南和哮喘管理工具来改变初级保健提供者的处方行为和慢性病管理。 CAMS 在三个方面不同于其他哮喘干预措施。 首先，它保留了临床医生的自主权。 其次，建议是由患者特定数据驱动的。 第三，CAMS 比被忽视更容易使用。 由于它是自动化的，因此它的成本可能比其他质量改进工作低得多。 我们将把三个不同儿科诊所的提供者随机分配到 CAMS 或常规护理。 我们假设 CAMS 将改善随机接受它的提供者的护理。 具体来说，我们假设 CAMS 提供者更有可能在适当时开出控制药物并准备书面哮喘护理计划；接受 CAMS 提供者护理的哮喘儿童出现症状的天数将会减少。 我们进一步假设 CAMS 不会导致提供商的净成本增加。 我们将通过计算机化数据和对 750 名患者/家长的电话采访前瞻性地收集有关药物使用、家庭护理、症状天数、健康状况、利用率和满意度的数据来评估 CAMS 的有效性。