Evaluation of the Emergency Department Asthma Care Project

This study has been completed.
Sponsor:
Collaborators:
Ontario Hospital Association
Ontario Ministry of Health and Long Term Care
Information provided by:
Queen's University
ClinicalTrials.gov Identifier:
NCT00268580
First received: December 20, 2005
Last updated: June 1, 2007
Last verified: January 2006
  Purpose

The purpose of the study is to evaluate whether the Emergency Department (ED) Asthma Care Project leads to improved asthma care delivery and patient outcomes in the ED setting.

Hypothesis: Implementation of a multi-disciplinary asthma strategy/clinical pathway for the treatment of asthma in the ED, based upon the 1999 Canadian Asthma Consensus Guidelines (and subsequent updates), will increase adherence with published management guidelines in the ED setting, reduce variations in the emergency management of acute asthma, increase utilization of specialized asthma services and improve outcomes for patients following ED visits.

Methods:

This observational, pre- post-intervention study will compare a stratified sample of 10 Ontario hospital EDs (5 intervention and 5 control sites). Chart abstractions will be performed on all adult visits for acute asthma over a 3 month period before and after implementation of the OHA’s ED Asthma Care Map. Patient and provider surveys and provider focus group post intervention will also be conducted. Primary outcome measures are hospitalizations and repeat ED visit rates. Secondary outcome measures include: length of stay in ED, self-reported adherence with referral to specialized asthma services made during index ED visit, self-reported asthma control, and use of self-management strategies (including use of action plan), use of asthma management strategies promoted by the care map (such as use of objective measure of airflow rates, use of steroids, education, referral to specialized asthma services on discharge). Ease of implementation and barriers to implementation will also be evaluated.


Condition Intervention
Asthma
Behavioral: Clinical pathway for asthma in the emergency department

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Official Title: Evaluation of the Emergency Department Asthma Care Project

Resource links provided by NLM:


Further study details as provided by Queen's University:

Primary Outcome Measures:
  • % of ED visitors admitted to hospital for asthma
  • Repeat Emergency Department visit rate for asthma

Secondary Outcome Measures:
  • Hospitalization rate and length of stay
  • Length of stay in ED
  • Relapse rate to the ED for asthma, within 24 and 72 hours of ED visit
  • Self-reported adherence with referral to specialized asthma services made during index ED visit
  • Self-reported asthma control, and use of self-management strategies (including use of action plan)
  • Use of Asthma Management Strategies Promoted by the ED ACP: use of objective measure of airflow rates (PEFR or spirometry), and gas exchange (oxygen saturation, arterial blood gases)
  • ; types of asthma medications prescribed (bronchodilators, corticosteroids) in ED and upon discharge; route of medications prescribed (IV vs oral vs. inhaled steroids; MDI vs nebulized bronchodilators)
  • ; documentation of assessment and teaching of device technique
  • ; documentation of asthma action plan provision or revision
  • ; type of asthma education provided (e.g. environmental trigger avoidance, warning signs, medication use)
  • ; follow-up care recommendations or referrals (AEC, Asthma Clinic, Respirology Clinic, family physician)
  • Utilization of Specialized Asthma Services
  • ; referral rates (#/year) to local AECs and Asthma Clinics
  • ; types of providers involved in emergency asthma care
  • Proportion of patients enrolled on the ED ACP (Overall, by patient age category and by physician specialty)
  • Differences in patient demographics, physician demographics, day of week, time of day between patients enrolled vs. not enrolled
  • Perceived utility of pathway (overall, by site, and by profession)

Estimated Enrollment: 300
Study Start Date: January 2006
Study Completion Date: June 2006
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   19 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • asthma plus or minus COPD
  • ED visit for acute asthma treatment
  • age 19 years or greater

Exclusion Criteria:

  • COPD without asthma
  • ED visit for asthma prescription renewal only
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00268580

Locations
Canada, Ontario
Chatham Kent Health Alliance
Chatham, Ontario, Canada, N7M 5L9
St. Joseph's Healthcare
Hamilton, Ontario, Canada, L8N 4A6
Lake of the Woods District Hospital
Kenora, Ontario, Canada, P9N 3W7
Lakeridge Health Hospital
Oshawa, Ontario, Canada, L1J 8R2
Grey Bruce Health Services
Owen Sound, Ontario, Canada, N4K 6M9
Prince Edward County Hospital
Picton, Ontario, Canada
Renfrew Victoria Hospital
Renfrew, Ontario, Canada, K7V 1P6
Sudbury Regional Hospital
Sudbury, Ontario, Canada, P3E 5J1
Sponsors and Collaborators
Queen's University
Ontario Hospital Association
Ontario Ministry of Health and Long Term Care
Investigators
Principal Investigator: Diane Lougheed, MD Queen's University
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00268580     History of Changes
Other Study ID Numbers: DMED-782-04, ORS # 2003-342
Study First Received: December 20, 2005
Last Updated: June 1, 2007
Health Authority: Canada: Ethics Review Committee

Keywords provided by Queen's University:
Asthma
Care map
Clinical pathway
Education
Emergency department

Additional relevant MeSH terms:
Asthma
Emergencies
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on September 30, 2014