MICT: Use of Mobile Devices and the Internet to Streamline an Asthma Clinical Trial

Sponsor
Nemours Children's Clinic (Other)
Overall Status
Completed
CT.gov ID
NCT02061280
Collaborator
National Heart, Lung, and Blood Institute (NHLBI) (NIH)
108
5
2
40.6
21.6
0.5

Study Details

Study Description

Brief Summary

Asthma is an inflammatory disease that imposes a significant burden affecting an estimated 300 million persons and 20% of all children worldwide. It is one of the most common chronic diseases of childhood and is a leading cause of school absenteeism. There continues to be a great need for clinical trials in asthma but traditional clinical trials are expensive and reasons cited by patients for non-participation are extra inconvenience and logistical barriers. Study designs which are patient centered and reduce trial costs are needed. The long-range goal of this application is to transform the paradigm of clinical research into a more efficient and cost-effective enterprise by capitalizing upon current widely used mobile electronic means of communication and information transfer.

This innovative project is a streamlined clinical trial that will run concurrently with a nearly identical traditional clinical trial, "Long-acting Beta Agonist Step Down Study" (LASST) which will allow for direct comparison of processes and outcomes between the streamlined and traditional approach. Children 12 to 17 years old with asthma will be randomized to participate in this project (streamlined trial) or LASST (traditional trial). In this proposal we will: measure comprehension of study information using an original questionnaire, Research Participant Assessment (developed at Nemours), following a parental permission/assent process delivered over the internet in a dynamic interactive multi-media format (Specific Aim 1); measure the efficiency of participant driven data entry from home into a Research Electronic Data Capture (REDCap) online database using the iPad, and quality of spirometry with the EasyOne Plus handheld meter with remote coaching using the iPad (Specific Aim 2); test whether the streamlined approach has a "trial effect" by comparing the differences in Asthma Control Test (ACT) scores following 12 weeks of study drug treatment in children randomized to this project compared to LASST. We will collect effort reporting data to compare personnel costs between the trials. If this streamlined project lacks a "trial effect" and reduces costs compared to LASST, the methodologies would be generalizable to studies which include adults and other diseases.

Condition or Disease Intervention/Treatment Phase
  • Drug: fluticasone/salmeterol 250/50 Dry Powder Inhaler
  • Drug: fluticasone/salmeterol 100/50 Dry Powder Inhaler
  • Drug: fluticasone 100mcg Dry Powder Inhaler
Phase 4

Detailed Description

Introduction Phase III / IV clinical trials are expensive and time consuming and often suffer from poor enrollment and retention rates. Pediatric trials are particularly difficult because scheduling around the parent, participant and potentially other sibling schedules can be burdensome. We are evaluating using the internet and mobile devices to conduct the consent process and study visits in a streamlined pediatric asthma trial. Our hypothesis is that these study processes will be noninferior and will be less expensive compared to a traditional pediatric asthma trial.

Materials/Methods Parents and participants, aged 12 through 17 years, complete the informed consent process by viewing a multi-media website containing a consent video and study material in the streamlined trial. Participants are provided an iPad with WiFi (wireless internet) and EasyOne spirometer for use during FaceTime visits and online twice daily symptom reporting during an 8-week run-in followed by 12-week study period. Outcomes are compared with participants completing a similarly designed traditional trial comparing the same treatments within the same pediatric health-system. After 8 weeks of open-label Advair 250/50 twice daily, participants in both trial types are randomized to Advair 250/50, Flovent 250, or Advair 100/50 given 1 inhalation twice daily. Study staff track time spent to determine study costs.

Results Participants have been enrolled in the streamlined and traditional trials and recruitment is ongoing.

Conclusions This project will provide important information on both clinical and economic outcomes for a novel method of conducting clinical trials. The results will be broadly applicable to trials of other diseases.

Study Design

Study Type:
Interventional
Actual Enrollment :
108 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Other
Official Title:
Use of Mobile Devices and the Internet to Streamline an Asthma Clinical Trial
Study Start Date :
Oct 1, 2013
Actual Primary Completion Date :
Feb 17, 2017
Actual Study Completion Date :
Feb 17, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: MICT Trial Design

Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily

Drug: fluticasone/salmeterol 250/50 Dry Powder Inhaler
Participants will receive Advair Diskus 250/50 Dry Powder Inhaler, administered twice daily for 12 weeks after randomization
Other Names:
  • Advair Diskus
  • Drug: fluticasone/salmeterol 100/50 Dry Powder Inhaler
    Participants will receive Advair Diskus 100/50 Dry Powder Inhaler administered twice daily for 12 weeks after randomization
    Other Names:
  • Advair Diskus
  • Drug: fluticasone 100mcg Dry Powder Inhaler
    Participants will receive Flovent Diskus 100mcg Dry Powder Inhaler administered twice daily for 12 weeks after randomization
    Other Names:
  • Flovent Diskus
  • Active Comparator: LASST Trial Design

    Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.

    Drug: fluticasone/salmeterol 250/50 Dry Powder Inhaler
    Participants will receive Advair Diskus 250/50 Dry Powder Inhaler, administered twice daily for 12 weeks after randomization
    Other Names:
  • Advair Diskus
  • Drug: fluticasone/salmeterol 100/50 Dry Powder Inhaler
    Participants will receive Advair Diskus 100/50 Dry Powder Inhaler administered twice daily for 12 weeks after randomization
    Other Names:
  • Advair Diskus
  • Drug: fluticasone 100mcg Dry Powder Inhaler
    Participants will receive Flovent Diskus 100mcg Dry Powder Inhaler administered twice daily for 12 weeks after randomization
    Other Names:
  • Flovent Diskus
  • Outcome Measures

    Primary Outcome Measures

    1. Adolescent Research Participant Assessment Score at Screening (Visit 1, Week -8) [Screening (Visit 1, week -8)]

      The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 1, week -8) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.

    2. Caregiver Research Participant Assessment Score at Screening (Visit 1, Week -8) [Screening (Visit 1, week -8)]

      The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 1, week -8) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.

    Secondary Outcome Measures

    1. Adolescent Research Participant Assessment Score at Study End (Visit 6, Week 12) [Final Visit (Visit 6, Week12)]

      The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 6, week 12) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.

    2. Caregiver Research Participant Assessment Score at Study End (Visit 6, Week 12) [Final Visit (Visit 6, Week12)]

      The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 6, week 12) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.

    3. Asthma Control Test Scores at Screening (Visit 1, Week -8) [Screening (Visit 1, week -8)]

      The Asthma Control Test is a 5-item Likert scale questionnaire; Scaling of items 5-point scale (for symptoms and activities: 1=all the time to 5= not at all; for asthma control rating: 1=not controlled at all to 5=completely controlled); The score for each item is summed to generate a total score. The scores range from 5 (poor control of asthma) to 25 (complete control of asthma), with higher scores reflecting greater asthma control. An ACT score >19 indicates well-controlled asthma. The study was powered to have greater than 90% power to detect a clinically meaningful difference of 3 in the ACT score between the MICT Trial Design and the LASST trial Design , assuming a mean score of 19 with a standard deviation of 4 (data from a previous ALA-ACRC trial).

    4. Asthma Control Test Score at Final Visit (Visit 6, Week12) [Final Visit (Visit 6, Week 12)]

      The Asthma Control Test is a 5-item Likert scale questionnaire; Scaling of items 5-point scale (for symptoms and activities: 1=all the time to 5= not at all; for asthma control rating: 1=not controlled at all to 5=completely controlled); The score for each item is summed to generate a total score. The scores range from 5 (poor control of asthma) to 25 (complete control of asthma), with higher scores reflecting greater asthma control. An ACT score >19 indicates well-controlled asthma. The study was powered to have greater than 90% power to detect a clinically meaningful difference of 3 in the ACT score between the MICT Trial Design and the LASST trial Design , assuming a mean score of 19 with a standard deviation of 4 (data from a previous ALA-ACRC trial).

    5. Spirometry Quality Control Grade [Visit 3 (week 0)]

      Spirometry grade scores in MICT participants (who performed spirometry at home) were compared with spirometry grade scores in LASST participants (who performed spirometry at the study sites). Spirometry grade scores were only available for LASST participants at Visit 3 (week 0), therefore only spirometry grade scores from Visit 3 were compared between MICT and LASST participants. Per the LASST trial no scoring was performed on the LASST participants for any other visit; the scoring for the LASST trial was for quality control only and was not a pre-specified trial outcome. Spirometry grade score scale was: 4.00 (highest=best possible score), 3.00, 2.00, 1.00, 0.00 (lowest=worst possible score). The maximum score was 4.00, the minimum score was 0.00. Higher scores indicate better spirometry score and therefore better quality.

    6. Number of Errors in Questionnaires Completed by Participants at Visit 1 (Week -8). [Visit 1 (week -8)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    7. Number of Errors in Questionnaires Completed by Participants at Visit 2 (Week -4). [Visit 2 (week -4)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    8. Number of Errors in Questionnaires Completed by Participants at Visit 3 (Week 0). [Visit 3 (week 0)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    9. Number of Errors in Questionnaires Completed by Participants at Visit 4 (Week 3). [Visit 4 (week 3)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    10. Number of Errors in Questionnaires Completed by Participants at Visit 5 (Week 6). [Visit 5 (week 6)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    11. Number of Errors in Questionnaires Completed by Participants at Visit 6 (Week 12). [Visit 6 (week 12)]

      This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    12 Years to 17 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No

    Main Trial

    Inclusion Criteria:
    • Age 12-17 years

    • Physician diagnosed asthma (without any other co-morbid pulmonary disease) that is well-controlled on medium dose inhaled corticosteroid and long-acting β2-agonist given twice daily [Advair Diskus (fluticasone propionate/salmeterol) 250/50mcg; Advair HFA (hydrofluoroalkane) (fluticasone propionate/salmeterol hydrofluoroalkane) 115/21mcg; Symbicort (budesonide/formoterol) 160/4.5mcg; Dulera (mometasone/formoterol) 100/4.5mcg] based on an ACT score > 20, and the absence of unscheduled visits or use of rescue prednisone for 4 weeks prior to enrollment

    • Pre-bronchodilator forced expiratory volume in the first second > 70% predicted

    • < 10 pack/year history of tobacco use and abstinence for at least 1 year

    Exclusion Criteria:
    • Chronic oral steroid therapy

    • Hospitalization or urgent care visit within 4 weeks of the screening visit

    • Near fatal asthma within 2 years of enrollment or high risk of near fatal or fatal asthma 125-127

    • Women who are pregnant or lactating

    Parallel MICT and Parallel LASST

    Inclusion Criteria:
    • Age 12-17 years

    • Physician diagnosed asthma (without any other co-morbid pulmonary disease) that is well-controlled on medium dose inhaled corticosteroid and long-acting β2-agonist given twice daily [Advair Diskus (fluticasone propionate/salmeterol) 250/50mcg; Advair HFA (hydrofluoroalkane) (fluticasone propionate/salmeterol hydrofluoroalkane) 115/21mcg; Symbicort (budesonide/formoterol) 160/4.5mcg; Dulera (mometasone/formoterol) 100/4.5mcg] based on an ACT score > 20, and the absence of unscheduled visits or use of rescue prednisone for 4 weeks prior to enrollment

    • < 10 pack/year history of tobacco use and abstinence for at least 1 year

    Exclusion Criteria:
    • Chronic oral steroid therapy

    • Hospitalization or urgent care visit within 4 weeks of the screening visit

    • Near fatal asthma within 2 years of enrollment or high risk of near fatal or fatal asthma 125-127

    • Women who are pregnant or lactating

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Alfred I. duPont Hospital for Children Wilmington Delaware United States 19803
    2 Nemours Children's Specialty Care Jacksonville Florida United States 32207
    3 Nemours Children's Hospital Orlando Florida United States 32806
    4 Nemours Children's Specialty Care Pensacola Florida United States 32504
    5 Washington University in St. Louis Saint Louis Missouri United States 63130

    Sponsors and Collaborators

    • Nemours Children's Clinic
    • National Heart, Lung, and Blood Institute (NHLBI)

    Investigators

    • Principal Investigator: Kathryn Blake, PharmD, Nemours Children's Clinic Jacksonville FL

    Study Documents (Full-Text)

    More Information

    Publications

    Responsible Party:
    Nemours Children's Clinic
    ClinicalTrials.gov Identifier:
    NCT02061280
    Other Study ID Numbers:
    • 332965
    • R01HL114899
    First Posted:
    Feb 12, 2014
    Last Update Posted:
    Dec 19, 2018
    Last Verified:
    Nov 1, 2018
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Keywords provided by Nemours Children's Clinic
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Period Title: Overall Study
    STARTED 71 37
    Randomized to Treatment 54 25
    COMPLETED 53 25
    NOT COMPLETED 18 12

    Baseline Characteristics

    Arm/Group Title MICT Trial Design LASST Trial Design Total
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Total of all reporting groups
    Overall Participants 54 25 79
    Age (years) [Median (Inter-Quartile Range) ]
    Median (Inter-Quartile Range) [years]
    14
    15
    14
    Sex: Female, Male (Count of Participants)
    Female
    22
    40.7%
    12
    48%
    34
    43%
    Male
    32
    59.3%
    13
    52%
    45
    57%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    49
    90.7%
    2
    8%
    51
    64.6%
    Not Hispanic or Latino
    5
    9.3%
    23
    92%
    28
    35.4%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    2
    3.7%
    0
    0%
    2
    2.5%
    Asian
    1
    1.9%
    0
    0%
    1
    1.3%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    16
    29.6%
    10
    40%
    26
    32.9%
    White
    30
    55.6%
    15
    60%
    45
    57%
    More than one race
    5
    9.3%
    0
    0%
    5
    6.3%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Region of Enrollment (participants) [Number]
    United States
    54
    100%
    25
    100%
    79
    100%
    Unscheduled Health Care Visit in Past 12 Months (Count of Participants)
    Count of Participants [Participants]
    23
    42.6%
    9
    36%
    32
    40.5%

    Outcome Measures

    1. Primary Outcome
    Title Adolescent Research Participant Assessment Score at Screening (Visit 1, Week -8)
    Description The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 1, week -8) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.
    Time Frame Screening (Visit 1, week -8)

    Outcome Measure Data

    Analysis Population Description
    One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 53 25
    Mean (95% Confidence Interval) [Scores on a scale]
    41.08
    42.26
    2. Primary Outcome
    Title Caregiver Research Participant Assessment Score at Screening (Visit 1, Week -8)
    Description The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 1, week -8) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.
    Time Frame Screening (Visit 1, week -8)

    Outcome Measure Data

    Analysis Population Description
    One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6. Thus, the caregiver did not complete the Research Participant Assessment at Visit 6.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description MICT Trial: Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 53 25
    Mean (95% Confidence Interval) [Scores on a scale]
    43.2
    42.9
    3. Secondary Outcome
    Title Adolescent Research Participant Assessment Score at Study End (Visit 6, Week 12)
    Description The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 6, week 12) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.
    Time Frame Final Visit (Visit 6, Week12)

    Outcome Measure Data

    Analysis Population Description
    One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.
    Measure Participants 53 25
    Mean (95% Confidence Interval) [Scores on a scale]
    41.22
    41.27
    4. Secondary Outcome
    Title Caregiver Research Participant Assessment Score at Study End (Visit 6, Week 12)
    Description The Research Participant Assessment Score (RPA Comprehension) was a 17-item questionnaire designed to assess comprehension of study information at screening (Visit 6, week 12) between MICT and LASST trial designs. The same 17-item questionnaire was administered to the adolescent participant and to the caregiver participant. The items were scored as 1=incorrect, 2=partially correct, 3=correct (minimum possible score=17 and maximum possible score=51). Scores were assigned by two trained coders who independently listed to audio recordings of the RPA Comprehension questionnaire administration. Scores from the two coders were averaged for a final score. Higher scores indicate better comprehension. Mean (95% Confidence Interval) are the outcome measure reported.
    Time Frame Final Visit (Visit 6, Week12)

    Outcome Measure Data

    Analysis Population Description
    One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6. Thus, the caregiver did not complete the Research Participant Assessment at Visit 6.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.
    Measure Participants 53 25
    Mean (95% Confidence Interval) [Scores on a scale]
    43.28
    41.08
    5. Secondary Outcome
    Title Asthma Control Test Scores at Screening (Visit 1, Week -8)
    Description The Asthma Control Test is a 5-item Likert scale questionnaire; Scaling of items 5-point scale (for symptoms and activities: 1=all the time to 5= not at all; for asthma control rating: 1=not controlled at all to 5=completely controlled); The score for each item is summed to generate a total score. The scores range from 5 (poor control of asthma) to 25 (complete control of asthma), with higher scores reflecting greater asthma control. An ACT score >19 indicates well-controlled asthma. The study was powered to have greater than 90% power to detect a clinically meaningful difference of 3 in the ACT score between the MICT Trial Design and the LASST trial Design , assuming a mean score of 19 with a standard deviation of 4 (data from a previous ALA-ACRC trial).
    Time Frame Screening (Visit 1, week -8)

    Outcome Measure Data

    Analysis Population Description
    The participant data set includes all participants who were randomized in each arm, the MICT trial design or LASST trial design. One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6. The last available ACT score was used for this participant.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.
    Measure Participants 54 25
    Median (Inter-Quartile Range) [scores on a scale]
    22
    22
    6. Secondary Outcome
    Title Asthma Control Test Score at Final Visit (Visit 6, Week12)
    Description The Asthma Control Test is a 5-item Likert scale questionnaire; Scaling of items 5-point scale (for symptoms and activities: 1=all the time to 5= not at all; for asthma control rating: 1=not controlled at all to 5=completely controlled); The score for each item is summed to generate a total score. The scores range from 5 (poor control of asthma) to 25 (complete control of asthma), with higher scores reflecting greater asthma control. An ACT score >19 indicates well-controlled asthma. The study was powered to have greater than 90% power to detect a clinically meaningful difference of 3 in the ACT score between the MICT Trial Design and the LASST trial Design , assuming a mean score of 19 with a standard deviation of 4 (data from a previous ALA-ACRC trial).
    Time Frame Final Visit (Visit 6, Week 12)

    Outcome Measure Data

    Analysis Population Description
    The participant data set includes all participants who were randomized in each arm, the MICT trial design or LASST trial design. One participant in the MICT trial arm who was randomized to treatment at Visit 3 did not complete the study through Visit 6. The last available ACT score was used for this participant.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.
    Measure Participants 54 25
    Median (Inter-Quartile Range) [scores on a scale]
    24
    23
    7. Secondary Outcome
    Title Spirometry Quality Control Grade
    Description Spirometry grade scores in MICT participants (who performed spirometry at home) were compared with spirometry grade scores in LASST participants (who performed spirometry at the study sites). Spirometry grade scores were only available for LASST participants at Visit 3 (week 0), therefore only spirometry grade scores from Visit 3 were compared between MICT and LASST participants. Per the LASST trial no scoring was performed on the LASST participants for any other visit; the scoring for the LASST trial was for quality control only and was not a pre-specified trial outcome. Spirometry grade score scale was: 4.00 (highest=best possible score), 3.00, 2.00, 1.00, 0.00 (lowest=worst possible score). The maximum score was 4.00, the minimum score was 0.00. Higher scores indicate better spirometry score and therefore better quality.
    Time Frame Visit 3 (week 0)

    Outcome Measure Data

    Analysis Population Description
    Twenty percent (20%) of available participant scores from Visit 3 (week 0) were randomly selected for analysis; N=11 participant scores were selected from the MICT Trial (20% of 54 scores =11). Eleven (11) participant scores were randomly selected from the LASST trial for analysis.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily, or fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily.
    Measure Participants 11 11
    Median (Inter-Quartile Range) [scores on a scale]
    3.75
    4.00
    8. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 1 (Week -8).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 1 (week -8)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0
    9. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 2 (Week -4).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 2 (week -4)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0
    10. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 3 (Week 0).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 3 (week 0)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0
    11. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 4 (Week 3).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 4 (week 3)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0
    12. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 5 (Week 6).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 5 (week 6)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0
    13. Secondary Outcome
    Title Number of Errors in Questionnaires Completed by Participants at Visit 6 (Week 12).
    Description This outcome was to measure differences in timeliness and completeness of forms completed at home through REDCap in MICT participants compared with LASST participants. No data were collected for this outcome. This is because in designing the REDCap database used to send questionnaires to the MICT trial participants and to store the responses from the completed questionnaires, data checks were put into place to prevent incomplete forms. We did this by requiring all fields to be completed before the questionnaire could be submitted. If a questionnaire was not submitted, the study coordinator re-sent the questionnaire to the participant and the questionnaire was completed during the FaceTime visit. For the LASST participants, the study coordinator reviewed all forms the participant completed at the study site visit and any incomplete fields were completed at the time of the study site visit.
    Time Frame Visit 6 (week 12)

    Outcome Measure Data

    Analysis Population Description
    No data were collected for this outcome.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    Measure Participants 0 0

    Adverse Events

    Time Frame The adverse events were recorded starting the visit after treatment randomization at Visit 3 to Visit 6 for a period of 12 weeks in both the MICT and LASST trial.
    Adverse Event Reporting Description The data form used to collect adverse events specified specific symptoms that were most likely thought to occur in patients with asthma. In addition, the form listed specific new diagnoses that were thought most likely to occur in the study population. Lastly, the form included 4 fields to list any new symptom or diagnosis that was not previously specified on the form. If a subject experienced more than 1 of a given AE, the subject is counted only once for that AE.
    Arm/Group Title MICT Trial Design LASST Trial Design
    Arm/Group Description MICT Trial: Participants randomized to MICT will complete study procedures using an iPad for data entry and FaceTime visits rather than coming into the study site for onsite visits. Participants will perform spirometry at home using a handheld spirometer, EasyOne Plus. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily Participants randomized to LASST will complete study procedures in the traditional format in which all study visits are conducted at the study site, all questionnaires are completed by pen/paper, and all spirometry is performed at the clinic site. Randomized to one of 3 study treatments: fluticasone/salmeterol 250/50 Dry Powder Inhaler one inhalation twice daily fluticasone/salmeterol 100/50 Dry Powder Inhaler one inhalation twice daily fluticasone 100mcg Dry Powder Inhaler one inhalation twice daily
    All Cause Mortality
    MICT Trial Design LASST Trial Design
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/53 (0%) 0/25 (0%)
    Serious Adverse Events
    MICT Trial Design LASST Trial Design
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 2/53 (3.8%) 1/25 (4%)
    Nervous system disorders
    Unsteady gait 1/53 (1.9%) 1 0/25 (0%) 0
    Psychiatric disorders
    Suicidality 0/53 (0%) 0 1/25 (4%) 1
    Respiratory, thoracic and mediastinal disorders
    acute chest syndrome 1/53 (1.9%) 1 0/25 (0%) 0
    Other (Not Including Serious) Adverse Events
    MICT Trial Design LASST Trial Design
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 42/53 (79.2%) 10/25 (40%)
    Cardiac disorders
    Chest pain 15/53 (28.3%) 24 2/25 (8%) 2
    Increased or irregular heartbeat 7/53 (13.2%) 8 0/25 (0%) 0
    Gastrointestinal disorders
    Nausea and/or vomiting 9/53 (17%) 10 1/25 (4%) 1
    General disorders
    Headache 22/53 (41.5%) 43 4/25 (16%) 4
    Musculoskeletal and connective tissue disorders
    Muscle or joint pain 9/53 (17%) 14 1/25 (4%) 1
    Bone fracture 1/53 (1.9%) 1 1/25 (4%) 1
    Nervous system disorders
    Restlessness or nervousness 6/53 (11.3%) 12 0/25 (0%) 0
    Tremor 6/53 (11.3%) 12 0/25 (0%) 0
    Respiratory, thoracic and mediastinal disorders
    Upper respiratory tract infection 11/53 (20.8%) 14 3/25 (12%) 3
    Sore throat 19/53 (35.8%) 29 0/25 (0%) 0
    Hoarseness 9/53 (17%) 13 1/25 (4%) 1
    Cough 29/53 (54.7%) 48 3/25 (12%) 3
    Runny nose and congestion 24/53 (45.3%) 45 2/25 (8%) 2
    Acute sinusitis 1/53 (1.9%) 1 1/25 (4%) 1
    Skin and subcutaneous tissue disorders
    Skin bruising 3/53 (5.7%) 4 0/25 (0%) 0

    Limitations/Caveats

    Allocation to trial type was not randomized; enrollment in LASST began 1 year before MICT, and LASST enrollment was competitive across the network. Parents and adolescents likely had varying cognitive abilities and experience with e-learning.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Kathryn Blake, Pharm.D.
    Organization Nemours Children's Specialty Care
    Phone 9046865047 ext 904
    Email kathryn.blake@nemours.org
    Responsible Party:
    Nemours Children's Clinic
    ClinicalTrials.gov Identifier:
    NCT02061280
    Other Study ID Numbers:
    • 332965
    • R01HL114899
    First Posted:
    Feb 12, 2014
    Last Update Posted:
    Dec 19, 2018
    Last Verified:
    Nov 1, 2018