RECRUITINGINTERVENTIONAL

SMART Implementation-Effectiveness Trial 1

Single Maintenance And Reliever Therapy Strategies for IMPLementation and Effectiveness (SMART & SIMPLE) Trial

About This Trial

While single maintenance and reliever therapy (SMART) has been the preferred management strategy for Step 3 and 4 (moderate/severe) asthma management since the 2020 NIH asthma guideline updates, adoption of SMART has not been rigorously assessed. This study will test electronic medical record clinical decision support and education implementation strategies (CDS+) to increase adoption of SMART in pediatric primary care. This is the first of two related records.

Who May Be Eligible (Plain English)

Clinic Who May Qualify: - The clinic is a pediatric primary care clinic that is part of the Children's Hospital of Philadelphia (CHOP) Pediatric Research Consortium (PeRC). - The clinic agrees to participate in SMART \& SIMPLE study. Clinic Who Should NOT Join This Trial: \- The clinic is not willing to participate in SMART \& SIMPLE study interventions. Patient Who May Qualify: - Ages 5-18 years; - Has clinic visit at participating practice during study interval (sick, well, or follow-up) - Prescribed at least one prescription for an inhaled corticosteroid (ICS) or ICS-long-acting beta agonist (ICS-LABA) for maintenance asthma therapy in the past year; - Evidence of uncontrolled asthma as determined by: (1) uncontrolled Asthma Control Tool score in the past 6 months OR (2) two or more systemic corticosteroids prescribed for an asthma exacerbation in the past 12 months (one occurring in the past 6 months) Patient Who Should NOT Join This Trial: \- Transferred clinics or left the CHOP Pediatric Care Network. Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Clinic Inclusion Criteria: * The clinic is a pediatric primary care clinic that is part of the Children's Hospital of Philadelphia (CHOP) Pediatric Research Consortium (PeRC). * The clinic agrees to participate in SMART \& SIMPLE study. Clinic Exclusion Criteria: \- The clinic is not willing to participate in SMART \& SIMPLE study interventions. Patient Inclusion Criteria: * Ages 5-18 years; * Has clinic visit at participating practice during study interval (sick, well, or follow-up) * Prescribed at least one prescription for an inhaled corticosteroid (ICS) or ICS-long-acting beta agonist (ICS-LABA) for maintenance asthma therapy in the past year; * Evidence of uncontrolled asthma as determined by: (1) uncontrolled Asthma Control Tool score in the past 6 months OR (2) two or more systemic corticosteroids prescribed for an asthma exacerbation in the past 12 months (one occurring in the past 6 months) Patient Exclusion Criteria: \- Transferred clinics or left the CHOP Pediatric Care Network.

Treatments Being Tested

BEHAVIORAL

Clinical decision support + education (CDS+)

Intervention clinic providers will experience nudges in the electronic medical record to encourage prescribing SMART where clinically-appropriate and intervention clinic providers, families/patients, and nurses will receive education (collectively CDS+).

OTHER

Control

Clinics in Arm 2 will not be exposed to the interventions.

Locations (1)

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States