Conducting Annual Asthma Reviews Using Telehealthcare: Comparison With Standard Care (Face-to-face Consultations)
Study Details
Study Description
Brief Summary
The National Report of Asthma Deaths published in 2014 highlighted significant deficiencies in both primary and secondary care resulting in one of the highest mortality rates in Europe. A key recommendation in the report is the provision of an annual asthma review in primary care.
Telehealthcare is an alternative means of service delivery incorporating the use of telephone and e-mail consultations which may improve access and quality of patient care. There is scant data on the role of teleheathcare in asthma care.
This is a single-centre, primary care-based, randomized controlled trial to evaluate the use of telehealthcare to conduct the annual asthma review for adult patients with well-controlled asthma. This will be compared with standard care (face-to-face consultations).
Telehealthcare will consist of a telephone consultation followed by an e-mail with an attached personalised asthma action plan and a link to a video demonstrating inhaler technique.
Standard care will involve a face-to-face consultation in primary care. The two patient groups will be compared prospectively to determine whether there is a difference in the quality of care evaluated in terms of the patient experience/ satisfaction, health-related quality of life, asthma control and frequency of asthma exacerbations over a 6 month period after the asthma review.
The data will be presented in the form of frequency tables, bar charts and pie charts. Non-parametric tests will be applied to determine whether there is a significant difference in the quality of care received.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Standard care Patients will receive a face-to-face asthma review |
|
| Active Comparator: Telehealthcare Patients will receive a telephone consultation and e-mail with attached PAAP and video link |
Other: Telehealthcare
Telephone consultation plus e-mail with attached PAAP and video link
|
Outcome Measures
Primary Outcome Measures
- Patient Experience: overall patient experience score (General Practice Assessment Questionnaire GPAQ score) [Up to 2 weeks after the asthma review]
The difference in the overall patient experience score (General Practice Assessment Questionnaire GPAQ score) between the two patient groups
Secondary Outcome Measures
- Did not attends ("DNA's"): number of DNA's in each patient group [Baseline]
It will be recorded whether a patient attends their asthma review or not at the time of the proposed review.
- Average consultation length (time) [Baseline]
The average time taken for a standard asthma review vs a telehealthcare review will be recorded at the time of the asthma review
- Health related quality of life score (Asthma Quality of Life Questionnaire (AQLQ)) [Baseline and 6 months]
Quality of life will be assessed using the Asthma Quality of Life Questionnaire (AQLQ) in each group at the start of the study (before the asthma review) and 6 months after the asthma review.
- Number of unplanned face-to-face consultations for asthma [3 months and 6 months]
The number of unplanned asthma consultations 3 months (interim analysis) and 6 months after the asthma review.
- Number of out-of-hours attendances for asthma [3 months and 6 months]
The number of out-of-hours attendances for asthma at 3 months (interim analysis) and 6 months after the asthma review.
- Number of hospital admissions for asthma [3 months and 6 months]
The number of hospital admissions for asthma at 3 months (interim analysis) and 6 months after the asthma review.
- Number of courses of systemic steroids for asthma [3 months and 6 months]
Number of courses of systemic steroids prescribed for asthma at 3 months (interim analysis) and 6 months after the asthma review.
- Asthma Control Test Score [Baseline and 6 months]
Assessment of asthma control using validated questionnaire at baseline (before the asthma review) and 6 months after the asthma review.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients aged 18 and over, registered at Balham Park Surgery
-
Patients diagnosed with asthma (patients on the asthma register)
-
Patients with well-controlled asthma (ACT score 20 and over; no out of hours/ A&E attendances/ PO steroids/ hospital admissions since the last asthma review in primary care)
Exclusion Criteria:
-
Patients aged less than 18
-
Patients with poorly controlled asthma (ACT score 19 or less; out of hours/ A&E attendance/ hospital admission/ PO steroids since last asthma review in primary care)
-
Patients with a mental health diagnosis
-
Patients without an up to date contact telephone number or with communication difficulties that would prevent or restrict their use of the technology.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Balham Park Surgery | London | United Kingdom | SW17 7AW |
Sponsors and Collaborators
- Imperial College London
Investigators
- Principal Investigator: Sarah Glynne, MRCP MRCGP, Balham Park Surgery, Wandsworth CCG
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 15IC2535