Internet Based Patient-Centered Asthma Management System

描述（由申请人提供）：从卫生服务的角度来看，提高哮喘护理的质量仍然是一个关键目标。这项随机对照试验建立在几个独立的、正在进行的、由联邦政府资助的研究项目的基础上，以开发和测试一个基于证据的、互动的互联网项目的能力，通过提高父母的哮喘护理技能，并激活父母与孩子的卫生保健提供者讨论哮喘护理的关键过程，来提高患有哮喘的幼儿的护理质量。一个关键特征将是提高卫生保健提供者提供哮喘护理的质量。AsthmaNet将为家长提供量身定制的临床信息，并帮助他们与医疗服务提供者分享决策。本研究将评估基于网络的交互式哮喘患者激活系统（AsthmaNet）在改变(1)家长对可改善儿童哮喘相关生活质量的实践的依从性和(2)初级保健提供者的处方行为和慢性疾病管理方面的有效性。AsthmaNet与其他哮喘干预措施（包括计算机化干预措施）的不同之处在于，它为2至10岁哮喘儿童的父母提供循证指南和哮喘管理工具，并注意他们的兴趣和自我管理技能，并向父母和提供者提供定期，自动化，量身定制的反馈，以帮助激励和维持父母和提供者在临床遇到时的哮喘管理技能和行为。在随机分配到AsthmaNet的受试者中，AsthmaNet将改善治疗过程和结果。我们的四个具体目标和假设是：目标1：增加儿童哮喘H1控制药物的适当使用。哮喘病家庭的儿童在适当的时候更有可能得到医生开具的控制药物。目的2：提高哮喘处方药物的依从性。H2。哮喘家庭儿童的父母将报告对处方哮喘药物的更大依从性目标3：增加书面哮喘护理计划的使用H3。哮喘家庭的孩子更有可能使用书面护理计划。目标4：减少哮喘儿童出现症状的天数。哮喘家庭的孩子出现症状的天数会更少。

DESCRIPTION (provided by applicant): From a Health Services perspective, improving the quality of asthma care remains a critical objective. This randomized controlled trial builds on several separate, ongoing, federally-funded research programs to develop and test an evidence-based, interactive internet program's ability to improve the quality of care for young children with asthma by enhancing parents asthma care skills and activating parents to discuss key processes of asthma care with their child's health care provider. A critical feature will be to improve the quality of asthma care delivery by health care providers. AsthmaNet will provide tailored clinical information to parents as well as give them decision aids to share with their providers. This study will gauge the effectiveness of an interactive web-based asthma patient activation system, AsthmaNet, in changing (1) parents' adherence to practices that can improve their children's asthma related quality of life and (2) primary care providers' prescribing behavior and chronic disease management. AsthmaNet differs from other asthma interventions (including computerized interventions) in that it delivers evidence-based guidelines and asthma management tools to parents of children with asthma between the ages of 2 and 10 years mindful of their interest and self-management skills and provides periodic, automated, tailored, feedback to parents and providers to help motivate and maintain asthma management skills and behaviors of both parents and providers during clinical encounters. AsthmaNet will result in improved processes and outcomes of care among subjects randomized to AsthmaNet. Our four specific aims and hypotheses are: Aim 1: To increase the appropriate use of controller medication in children with asthma H1. Children in AsthmaNet families will be more likely to have controller medication prescribed by their provider when appropriate. Aim 2: To improve adherence with prescribed asthma medications. H2. Parents of children in AsthmaNet families will report greater adherence to prescribed asthma medications Aim 3: To increase the use of written asthma care plans H3. Children in AsthmaNet families will be more likely to report using written care plans. Aim 4: to decrease the number of symptom days for children with asthma H4. Children in AsthmaNet families will experience fewer symptom days.