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Implementation of the Asthma Control Test in a Large Primary Care Network
Shilpa Sangvai1, Stephen J Hersey1, Dane A Snyder1
1Division of Ambulatory Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; Division of Pediatric Pulmonology, Nationwide Children's Hospital, Columbus, Ohio; and TransChart, LLC, Dublin, Ohio.
Insights
Implementing the Asthma Control Test (ACT) and Childhood Asthma Control Test (C-ACT) in primary care improved consistent asthma control assessment. This quality improvement project successfully integrated these tools into routine pediatric visits.
Area of Science:
- Pediatric Pulmonology
- Quality Improvement Science
- Primary Care Medicine
Background:
- Asthma control is a key objective in pediatric care, necessitating reliable assessment methods.
- This quality improvement initiative focused on integrating standardized asthma control assessments into a primary care setting.
- The Asthma Control Test (ACT) and Childhood Asthma Control Test (C-ACT) were selected for implementation.
Purpose of the Study:
- To implement and evaluate the integration of the ACT and C-ACT within a large primary care network.
- To establish a reliable and consistent method for assessing asthma control across all patient visit types.
- To achieve a target completion rate for ACT/C-ACT administration in pediatric asthma patients.
Main Methods:
- A prospective study design was employed to track provider documentation of ACT/C-ACT use.
- Patients aged 4 and older with asthma were administered either the ACT (12+) or C-ACT (4-11).
- The quality improvement project spanned 11 centers from November 2013 to December 2014, with a 70% completion rate goal.
Main Results:
- The project successfully achieved the 70% ACT/C-ACT completion rate within six months of implementation.
- Sustained completion rates exceeding 70% were observed through December 2016.
- Demonstrated feasibility of integrating asthma control assessments into a busy primary care network.
Conclusions:
- The ACT and C-ACT are effectively integrable into busy primary care settings.
- Consistent assessment of asthma control using validated tools is crucial for advancing pediatric asthma care.
- This approach represents a critical first step toward optimizing asthma management in children.
Introduction:
Achieving control in asthma is a primary goal of pediatric care, and assessing the degree of control is a principal step in management. The purpose of this quality improvement project was to implement the Asthma Control Test (ACT) and the Childhood Asthma Control Test (C-ACT) in a large primary care network as a means to reliably and consistently assess asthma control at all visit types.
Methods:
A prospective design was used to measure provider documentation of the ACT or C-ACT. Patients (or caregivers) 4 years of age or older with a known diagnosis of asthma were administered the ACT (ages 12 and older) or the C-ACT (ages, 4-11). The quality improvement project, which involved multiple interventions, took place at 11 centers of the Primary Care Network of Nationwide Children's Hospital from November 2013 to December 2014. A goal was set for a 70% completion rate of the ACT/C-ACT at any visit type for patients 4 years of age or older with asthma.
Results:
Six months after the introduction of the questionnaires, the 70% completion rate was reached. Rates of ACT/C-ACT completion have consistently exceeded 70% through December 2016.
Conclusions:
We demonstrated that the ACT/C-ACT can be integrated into a busy primary care network. It is imperative to work toward better asthma care; consistent assessment of asthma control can be the critical first step.
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