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Primary Care Pathway for Childhood Asthma: Protocol for a Randomized Cluster-Controlled Trial
Andrew J Cave1, Heather Sharpe, Mark Anselmo
1Department of Family Medicine, University of Alberta, Edmonton, AB, Canada. andrew.cave@ualberta.ca.
Insights
This study introduces a new electronic clinical pathway and education program to improve pediatric asthma management in primary care. The goal is to enhance asthma control, improve quality of life, and reduce healthcare costs for children.
Area of Science:
- Pediatric Pulmonology
- Primary Care Medicine
- Health Services Research
Background:
- Childhood asthma is a prevalent chronic condition with significant impact on children, families, and healthcare systems.
- Inadequate asthma control in children leads to increased hospitalizations and reduced quality of life.
- Primary care practitioners can improve asthma management by integrating evidence-based practices.
Purpose of the Study:
- To enhance the management of pediatric asthma through an electronic clinical pathway and train-the-trainer education program.
- To provide primary care practitioners with an integrated electronic guide for asthma management.
- To promote asthma education within primary care settings.
Main Methods:
- A pragmatic cluster-controlled trial design incorporating quantitative and qualitative methodologies.
- Economic evaluation to assess the cost-effectiveness of the intervention.
- Implementation of a clinical pathway and education intervention in primary care settings.
Main Results:
- The research secured funding and obtained ethics approvals.
- Practice recruitment commenced in Fall 2015, with study completion expected by March 2018.
- The intervention's effectiveness will be analyzed, with a strategy for broader implementation if positive.
Conclusions:
- The proposed clinical pathway and education intervention shows potential for improving pediatric asthma care in Alberta.
- The intervention is expected to enhance the quality of care for childhood asthma.
- The program aims to achieve better asthma management outcomes at a comparable or lower cost.
Background:
Asthma is the most common chronic condition in children. For many, the disease is inadequately controlled, which can burden the lives of children and their families as well as the health care system. Improved use of the best available scientific evidence by primary care practitioners could reduce the need for hospital care and improve quality of life and asthma control, thereby reducing overall costs to society and families.
Objective:
The Primary Care Pathway for Childhood Asthma aims to improve the management of children with asthma by (1) providing primary care practitioners with an electronic guide (a clinical pathway) incorporated into the patient's electronic medical record, and (2) providing train-the-trainer education to chronic disease management health professionals to promote the provision of asthma education in primary care.
Methods:
The research will utilize a pragmatic cluster-controlled design, quantitative and qualitative research methodologies, and economic evaluation to assess the implementation of a pathway and education intervention in primary care. The intervention will be analyzed for effectiveness, and if the results are positive, a strategy will be developed to implement delivery to all primary care practices in Alberta.
Results:
The research has been successfully funded and ethics approvals have been obtained. Practice recruitment began fall 2015, and we expect all study-related activities to be concluded by March 2018.
Conclusions:
The proposed pathway and education intervention has the potential to improve pediatric asthma management in Alberta. The intervention is anticipated to result in better quality of care for equal or lesser cost.
Clinicaltrial:
ClinicalTrials.gov NCT02481037; https://clinicaltrials.gov/ct2/show/NCT02481037 (Archived by WebCite at http://www.webcitation.org/6fPIQ02Ma).
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