Improving the Quality of Asthma Care Using the Internet

利用互联网提高哮喘护理质量

• 批准号: 8063127
• 负责人: CHRISTOPHER N. SCIAMANNA
• 金额: $ 37.82万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8063127
• 关键词: Accident and Emergency department; Adherence; Adrenal Cortex Hormones; Adult; Affect; American; Asthma; Breathing; Caring; Child; Chronic Disease; Clinical; Counseling; Dose; Education; Educational process of instructing; Enrollment; Environment; Facilities and Administrative Costs; Feedback; Goals; Guidelines; Health; Health Insurance; Health Planning; Home environment; Internet; Intervention; Lead; Learning; Link; Medicine; Morbidity - disease rate; Names; National Heart, Lung, and Blood Institute; Pap smear; Patient Care; Patient Noncompliance; Patients; Pennsylvania; Pharmaceutical Preparations; Physicians; Prevention program; Preventive; Productivity; Provider; Public Health; Publishing; Quality of Care; Quality of life; Randomized; Reading; Recommendation; Relative (related person); Sampling; Self Management; Services; Societies; Steroids; Surveys; Symptoms; Testing; Time; Visit; asthma inhaler; base; cost effectiveness; design; disability; efficacy testing; empowered; evidence based guidelines; improved; meetings; member; pill; programs; pulmonary function; response; satisfaction; web site

DESCRIPTION (provided by applicant): Asthma is one of the most important underlying causes of morbidity and lost productivity in the US. Though more US adults with asthma have controller medicines, fewer than half of adults have their asthma controlled. To improve the quality of asthma care in the US it is essential for providers to continue to intensify treatments (e.g., adding additional controller medications), in keeping with the NAEPP Guidelines, until asthma symptoms are controlled, as well as to consistently apply other recommendations from evidence-based guidelines. Prompting patients to ask doctors for tests and treatments improves preventive care, but its effect on asthma management has not been studied. We have developed an interactive website to be used by patients with asthma between and before doctor visits. The program asks patients questions about their asthma symptoms and medications. Based on responses to these questions and decision rules, patients are given personalized feedback. The feedback includes questions that the patient should consider asking during their next doctor visit, along with a lay explanation of why they should ask each question and links to reputable websites (e.g., NHLBI) for further reading on each topic. As patients tend to get tests and treatments that they ask their physicians for, the website is designed to activate patients to ask questions that lead to better asthma care. The main aim of the study is to test the efficacy of providing access to the asthma module of the interactive website. We will randomize 408 adults with asthma, who are members of Highmark, to use the asthma (IC) or preventive services module of the website for 12 months. We hypothesize that, after 12 months of using the website, 70% of patients in the IC will have controlled asthma, compared to 55% of patients in the CC. Uncontrolled asthma is one of the greatest threats to the public's health and the productivity of the US workforce. As three in four Americans now have access to the Internet, interventions being tested such as this interactive website hold great promise for improving asthma care and for improving the public's health by improving the quality of care for other common, chronic illnesses. PUBLIC HEALTH RELEVANCE: This study will test the efficacy of a website to be used by patients with asthma between and before visits with their asthma care provider. Patients enter information about their symptoms and medications, which is combined with decision rules from evidence-based guidelines to provide patients with personalized feedback. The feedback is designed to help patients know what to ask during doctor visits, in order to better control their asthma.

描述（由申请人提供）：哮喘是美国发病和生产力下降的最重要的根本原因之一。尽管美国有更多患有哮喘的成年人服用控制药物，但只有不到一半的成年人的哮喘得到控制。为了提高美国哮喘护理的质量，提供者必须根据 NAEPP 指南继续强化治疗（例如添加额外的控制药物），直到哮喘症状得到控制，并始终如一地应用其他建议来自基于证据的指南。促使患者向医生寻求检查和治疗可以改善预防保健，但其对哮喘管理的影响尚未得到研究。我们开发了一个交互式网站，供哮喘患者在就诊期间和之前使用。该计划询问患者有关哮喘症状和药物的问题。根据对这些问题的回答和决策规则，患者可以获得个性化的反馈。反馈包括患者在下次就诊时应考虑提出的问题，以及为什么应提出每个问题的简单解释以及信誉良好的网站（例如 NHLBI）的链接，以便进一步阅读每个主题。由于患者往往会向医生询问并接受检查和治疗，因此该网站旨在激发患者提出问题，从而获得更好的哮喘护理。该研究的主要目的是测试提供访问交互式网站哮喘模块的功效。我们将随机抽取 408 名患有哮喘的 Highmark 会员，使用该网站的哮喘 (IC) 或预防服务模块 12 个月。我们假设，使用该网站 12 个月后，IC 中 70% 的患者哮喘得到控制，而 CC 中这一比例为 55%。不受控制的哮喘是对公众健康和美国劳动力生产力的最大威胁之一。由于四分之三的美国人现在可以上网，正在测试的干预措施（例如这个交互式网站）有望改善哮喘护理，并通过提高其他常见慢性疾病的护理质量来改善公众健康。公共卫生相关性：本研究将测试哮喘患者在与哮喘护理提供者就诊期间和之前使用的网站的有效性。患者输入有关其症状和药物的信息，这些信息与基于证据的指南中的决策规则相结合，为患者提供个性化的反馈。这些反馈旨在帮助患者知道在就诊期间要问什么，以便更好地控制哮喘。

项目成果

A web-based patient activation intervention to improve hypertension care: study design and baseline characteristics in the web hypertension study.

基于网络的患者激活干预，以改善高血压护理：网络高血压研究中的研究设计和基线特征。

• DOI: 10.1016/j.cct.2010.08.012
• 发表时间: 2010
• 期刊: Contemporary clinical trials
• 影响因子: 2.2
• 作者: Thiboutot,Jeffrey;Stuckey,Heather;Binette,Aja;Kephart,Donna;Curry,William;Falkner,Bonita;Sciamanna,Christopher
• 通讯作者: Sciamanna,Christopher

Using positive deviance for determining successful weight-control practices.

使用正偏差来确定成功的体重控制实践。

• DOI: 10.1177/1049732310386623
• 发表时间: 2011
• 期刊: Qualitative health research
• 影响因子: 3.2
• 作者: Stuckey,HeatherL;Boan,Jarol;Kraschnewski,JenniferL;Miller-Day,Michelle;Lehman,ErikB;Sciamanna,ChristopherN
• 通讯作者: Sciamanna,ChristopherN

Chronic health conditions and internet behavioral interventions: a review of factors to enhance user engagement.

• DOI: 10.1097/ncn.0b013e3182065eed
• 发表时间: 2011-03
• 期刊: Computers, informatics, nursing : CIN
• 作者: Schubart JR;Stuckey HL;Ganeshamoorthy A;Sciamanna CN
• 通讯作者: Sciamanna CN