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）：总体目标是通过AHRQ PBRN中的比较有效性研究，确定改善哮喘患者健康结局的最佳实践。这一目标将通过完成以下目标来实现：（1）通过结合该国最大的医疗保健系统之一的临床和账单数据，创建一个用于哮喘比较有效性研究的集中数据库（医疗保健系统）与来自学校系统，医疗补助，病人和社区级数据集的数据;（2）在慢性病护理模式的基础上，采用一种全面发展的哮喘综合管理方法;（3）为来自弱势背景的哮喘患者制定和实施一种“共同决策”方法;（4）为现有的疾病预防控制中心资助的以学校为基础的哮喘干预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）评估和比较这三种哮喘管理策略的有效性：整体医疗保健消费和医疗费用;生活质量，学校缺勤率和表现;哮喘临床措施;和药物利用;和（6）通过全州PBRN和其他网络合作伙伴在全州传播调查结果。该项目有可能影响到全国30，000多名哮喘患者，其中包括许多来自弱势背景的患者。 公共卫生关系：该项目将开发一个集中的数据库，用于使用医院和社区数据进行比较有效性研究，以评估在北卡罗来纳州和南卡罗来纳州的75个实践和171所学校内实施的三种干预措施，其目标是改善哮喘结局。干预措施将包括：（1）综合护理模式，包括电子病历决策支持系统、电子哮喘行动计划、与社区资源的链接，以及实践重新设计和快速循环过程改进方面的培训;（2）为服务不足的社区成员提供共同决策干预，旨在加强患者在制定治疗计划方面的投入，并改善自我管理;以及（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建立联系。这项研究的结果和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范围内传播。

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