Effectiveness of the Spirometry 360 Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial.
Effectiveness of the Spirometry 360 Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial.
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DOI：
10.1016/j.acap.2017.06.015
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发表时间：
2017-11
影响因子：
3.1
通讯作者：
Stout JW
中科院分区：
文献类型：
--
作者：
Mangione-Smith R;Zhou C;Corwin MJ;Taylor JA;Rice F;Stout JW
确定肺功能测定360™远程学习质量改进（QI）计划在改善哮喘儿童护理过程和结果方面的有效性。涉及25对配对儿科初级保健实践的群集随机对照试验。从两个以实践为基础的研究网络招募实践：波士顿大学的斯隆中心以实践为基础的研究网络，波士顿，MA和华盛顿州西雅图的普吉特海湾儿科研究网络。研究参与者包括来自50个注册儿科诊所之一的提供者和626名哮喘患者。评估的过程措施包括：肺量测定测试质量和哮喘控制药物的适当处方。结果指标包括：哮喘特异性健康相关生活质量，以及哮喘的门诊、急诊和住院利用率。在基线时，25.4%的肺功能测定试验在控制实践中进行，50.4%的测试在干预实践中进行的高质量。在六个月的干预后期间，28.7%的肺功能测定测试进行控制的做法和49.9%的测试进行干预的做法是高质量的。调整后的差异差异分析显示，肺功能测定测试质量没有干预效果。调整后的差异差异分析也显示，对控制药物的适当使用或任何父母/患者报告的结果检查没有干预作用。在这项研究中，Spirometry 360™远程学习QI程序在改善肺功能测定测试质量或父母/患者报告的结果方面无效。这里评估的QI计划可能需要关注基线绩效水平较低的实践，或者为基线绩效较高的实践量身定制。
To determine the effectiveness of the Spirometry 360™ distance learning quality improvement (QI) program for enhancing the processes and outcomes of care for children with asthma. Cluster randomized controlled trial involving 25 matched pairs of pediatric primary care practices. Practices were recruited from two practice-based research networks: the Slone Center Office-based Research Network at Boston University, Boston, MA and the Puget Sound Pediatric Research Network in Seattle, WA. Study participants included providers from one of the 50 enrolled pediatric practices and 626 of their patients with asthma. Process measures assessed included: spirometry test quality and appropriate prescription of asthma controller medications. Outcome measures included: asthma-specific health-related quality of life, and outpatient, emergency department and inpatient utilization for asthma. At baseline, 25.4% of spirometry tests performed in control practices and 50.4% of tests performed in intervention practices were of high quality. During the six month post-intervention period, 28.7% of spirometry tests performed in control practices and 49.9% of tests performed in intervention practices were of high quality. The adjusted difference-of-differences analysis revealed no intervention effect on spirometry test quality. Adjusted differences-of-differences analysis also revealed no intervention effect on appropriate use of controller medications or any of the parent/patient-reported outcomes examined. In this study, the Spirometry 360™ distance learning QI program was ineffective in improving spirometry test quality or parent/patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or be tailored for those with higher baseline performance.
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影响因子：
3
作者：
Chan, KS;Mangione-Smith, R;Varni, JW
通讯作者：
Varni, JW
影响因子：
1.9
作者：
Seid, Michael;Limbers, Christine A.;Varni, James W.
通讯作者：
Varni, James W.
影响因子：
3.1
作者：
Stout, James W.;Smith, Karen;Mangione-Smith, Rita
通讯作者：
Mangione-Smith, Rita
影响因子：
2.6
作者：
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通讯作者：
Lindenauer, Peter K.
影响因子：
8
作者：
Cabana, M;Slish, KK;Dombkowski, KJ
通讯作者：
Dombkowski, KJ