Comparative Effectiveness of Asthma Interventions Within an AHRQ PBRN

AHRQ PBRN 内哮喘干预措施的有效性比较

• 批准号: 8053191
• 负责人: MICHAEL F DULIN
• 金额: $ 293.71万
• 依托单位: CAROLINAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8053191
• 关键词: Comparative; Effectiveness; Asthma; Interventions; Within

DESCRIPTION (provided by applicant): The overall goal is to indentify best practices for improving health outcomes for patients with asthma using comparative effectiveness research within an AHRQ PBRN. This goal will be achieved by completing the following aims: (1) Create a centralized database for comparative effectiveness research on asthma by combining clinical and billing data from one of the largest healthcare systems in the country (Carolinas Healthcare System) with data from the school system, Medicaid, and patient and community-level datasets; (2) Deploy a fully developed integrated approach to asthma management based on the Chronic Care Model; (3) Develop and implement a "shared decision making" approach for asthmatic patients from disadvantaged backgrounds; (4) Implement an electronic data collection system for an existing CDC funded school-based asthma intervention that will allow program evaluation and link school nurses with providers; (5) Evaluate and compare the effectiveness of these three asthma management strategies on: overall healthcare consumption and medical costs; quality of life, school absenteeism and performance; asthma clinical measures; and medication utilization; and (6) Disseminate findings across the state via the statewide PBRN and other network partners. This project has the potential to impact over 30,000 asthma patients across the Carolinas including many patients from disadvantaged backgrounds. PUBLIC HEALTH RELEVANCE: This project will develop a centralized database for comparative effectiveness research using hospital as well as community data in order to evaluate three interventions implemented with the goal of improving asthma outcomes within 75 practices and 171 schools in North and South Carolina. The interventions will include: (1) an integrated care model with an electronic medical record decision support system, an electronic asthma action plan, links to community resources, and training in practice redesign and rapid cycle process improvement; (2) a shared decision making intervention for underserved community members designed to enhance patient input in the development of the treatment plan and improve self-management; and (3) a school-based intervention lead by school nurses with links to primary care providers. Results from this study and the means to implement the interventions in everyday clinical settings will be disseminated across the state via the statewide AHRQ practice-based research networks and area health education centers.

描述（由申请人提供）：总体目标是利用 AHRQ PBRN 内的比较有效性研究来确定改善哮喘患者健康结果的最佳实践。这一目标将通过完成以下目标来实现：(1) 通过将美国最大的医疗保健系统之一（卡罗莱纳州医疗保健系统）的临床和计费数据与学校的数据相结合，创建一个用于哮喘比较有效性研究的集中数据库系统、医疗补助以及患者和社区级数据集； (2) 基于慢性护理模式部署全面开发的哮喘综合管理方法； (3) 为来自弱势背景的哮喘患者制定并实施“共同决策”方法； (4) 为现有的疾病预防控制中心资助的学校哮喘干预措施实施电子数据收集系统，该系统将允许项目评估并将学校护士与提供者联系起来； (5) 评估并比较这三种哮喘管理策略的有效性：总体医疗保健消费和医疗费用；生活质量、缺勤率和表现；哮喘临床措施；和药物的利用； (6) 通过全州 PBRN 和其他网络合作伙伴在全州传播调查结果。该项目有可能影响卡罗莱纳州超过 30,000 名哮喘患者，其中包括许多来自弱势群体的患者。 公共卫生相关性：该项目将开发一个集中数据库，利用医院和社区数据进行比较效果研究，以评估北卡罗来纳州和南卡罗来纳州 75 家诊所和 171 所学校为改善哮喘结果而实施的三项干预措施。干预措施将包括：（1）具有电子病历决策支持系统、电子哮喘行动计划、社区资源链接以及实践重新设计和快速周期流程改进培训的综合护理模式； (2) 对服务不足的社区成员进行共同决策干预，旨在加强患者对治疗计划制定的投入并改善自我管理； (3) 由学校护士领导的以学校为基础的干预措施，并与初级保健提供者有联系。这项研究的结果以及在日常临床环境中实施干预措施的方法将通过全州 AHRQ 基于实践的研究网络和地区健康教育中心在全州传播。

项目成果

Impact of shared decision making on asthma quality of life and asthma control among children.

共同决策对儿童哮喘生活质量和哮喘控制的影响。

• DOI: 10.1080/02770903.2017.1362423
• 发表时间: 2018
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Taylor,YhennekoJ;Tapp,Hazel;Shade,LindsayE;Liu,Tsai-Ling;Mowrer,JessicaLauren;Dulin,MichaelF
• 通讯作者: Dulin,MichaelF

Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care.

• DOI: 10.1177/1535370214525302
• 发表时间: 2014-11
• 期刊: Experimental biology and medicine (Maywood, N.J.)
• 作者: Mohanan S;Tapp H;McWilliams A;Dulin M
• 通讯作者: Dulin M

Adapting community based participatory research (CBPR) methods to the implementation of an asthma shared decision making intervention in ambulatory practices.

• DOI: 10.3109/02770903.2013.876430
• 发表时间: 2014-05
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Tapp H;Kuhn L;Alkhazraji T;Steuerwald M;Ludden T;Wilson S;Mowrer L;Mohanan S;Dulin MF
• 通讯作者: Dulin MF