Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial
<p>Abstract</p> <p>Background</p> <p>Internet-based self-management (IBSM) support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days, and lung function in patients with mild to moderate persistent asthma. The current c...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-11-01
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| Series: | Implementation Science |
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| Online Access: | http://www.implementationscience.com/content/7/1/113 |
| _version_ | 1819089011936854016 |
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| author | van Gaalen Johanna L Bakker Moira J van Bodegom-Vos Leti Snoeck-Stroband Jiska B Assendelft Willem JJ Kaptein Ad A van der Meer Victor Taube Christian Thoonen Bart P Sont Jacob K |
| author_facet | van Gaalen Johanna L Bakker Moira J van Bodegom-Vos Leti Snoeck-Stroband Jiska B Assendelft Willem JJ Kaptein Ad A van der Meer Victor Taube Christian Thoonen Bart P Sont Jacob K |
| author_sort | van Gaalen Johanna L |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Internet-based self-management (IBSM) support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days, and lung function in patients with mild to moderate persistent asthma. The current challenge is to implement IBSM in clinical practice.</p> <p>Methods/design</p> <p>This study is a three-arm cluster randomized trial with a cluster pre-randomisation design and 12 months follow-up per practice comparing the following three IBSM implementation strategies: minimum strategy (MS): dissemination of the IBSM program; intermediate strategy (IS): MS + start-up support for professionals (<it>i.e.</it>, support in selection of the appropriate population and training of professionals); and extended strategy (ES): IS + additional training and ongoing support for professionals. Because the implementation strategies (interventions) are primarily targeted at general practices, randomisation will occur at practice level.</p> <p>In this study, we aim to evaluate 14 primary care practices per strategy in the Leiden-The Hague region, involving 140 patients per arm. Patients aged 18 to 50 years, with a physician diagnosis of asthma, prescription of inhaled corticosteroids, and/or montelukast for ≥3 months in the previous year are eligible to participate. Primary outcome measures are the proportion of referred patients that participate in IBSM, and the proportion of patients that have clinically relevant improvement in the asthma-related quality of life. The secondary effect measures are clinical outcomes (asthma control, lung function, usage of airway treatment, and presence of exacerbations); self-management related outcomes (health education impact<it>,</it> medication adherence, and illness perceptions); and patient utilities. Process measures are the proportion of practices that participate in IBSM and adherence of professionals to implementation strategies. Cost-effective measurements are medical costs and healthcare consumption. Follow-up is six months per patient.</p> <p>Discussion</p> <p>This study provides insight in the amount of support that is required by general practices for cost-effective implementation of IBSM. Additionally, design and results can be beneficial for implementation of other self-management initiatives in clinical practice.</p> <p>Trial registration</p> <p>the Netherlands National Trial Register NTR2970</p> |
| first_indexed | 2024-12-21T22:01:09Z |
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| language | English |
| last_indexed | 2024-12-21T22:01:09Z |
| publishDate | 2012-11-01 |
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| series | Implementation Science |
| spelling | doaj.art-1ef3f312b6fa4f01a7053644bf86baf12022-12-21T18:48:48ZengBMCImplementation Science1748-59082012-11-017111310.1186/1748-5908-7-113Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trialvan Gaalen Johanna LBakker Moira Jvan Bodegom-Vos LetiSnoeck-Stroband Jiska BAssendelft Willem JJKaptein Ad Avan der Meer VictorTaube ChristianThoonen Bart PSont Jacob K<p>Abstract</p> <p>Background</p> <p>Internet-based self-management (IBSM) support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days, and lung function in patients with mild to moderate persistent asthma. The current challenge is to implement IBSM in clinical practice.</p> <p>Methods/design</p> <p>This study is a three-arm cluster randomized trial with a cluster pre-randomisation design and 12 months follow-up per practice comparing the following three IBSM implementation strategies: minimum strategy (MS): dissemination of the IBSM program; intermediate strategy (IS): MS + start-up support for professionals (<it>i.e.</it>, support in selection of the appropriate population and training of professionals); and extended strategy (ES): IS + additional training and ongoing support for professionals. Because the implementation strategies (interventions) are primarily targeted at general practices, randomisation will occur at practice level.</p> <p>In this study, we aim to evaluate 14 primary care practices per strategy in the Leiden-The Hague region, involving 140 patients per arm. Patients aged 18 to 50 years, with a physician diagnosis of asthma, prescription of inhaled corticosteroids, and/or montelukast for ≥3 months in the previous year are eligible to participate. Primary outcome measures are the proportion of referred patients that participate in IBSM, and the proportion of patients that have clinically relevant improvement in the asthma-related quality of life. The secondary effect measures are clinical outcomes (asthma control, lung function, usage of airway treatment, and presence of exacerbations); self-management related outcomes (health education impact<it>,</it> medication adherence, and illness perceptions); and patient utilities. Process measures are the proportion of practices that participate in IBSM and adherence of professionals to implementation strategies. Cost-effective measurements are medical costs and healthcare consumption. Follow-up is six months per patient.</p> <p>Discussion</p> <p>This study provides insight in the amount of support that is required by general practices for cost-effective implementation of IBSM. Additionally, design and results can be beneficial for implementation of other self-management initiatives in clinical practice.</p> <p>Trial registration</p> <p>the Netherlands National Trial Register NTR2970</p>http://www.implementationscience.com/content/7/1/113AsthmaSelf-managementTelemanagementE-healthSelf-managementImplementationChronic care |
| spellingShingle | van Gaalen Johanna L Bakker Moira J van Bodegom-Vos Leti Snoeck-Stroband Jiska B Assendelft Willem JJ Kaptein Ad A van der Meer Victor Taube Christian Thoonen Bart P Sont Jacob K Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial Implementation Science Asthma Self-management Telemanagement E-health Self-management Implementation Chronic care |
| title | Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial |
| title_full | Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial |
| title_fullStr | Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial |
| title_full_unstemmed | Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial |
| title_short | Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial |
| title_sort | implementation strategies of internet based asthma self management support in usual care study protocol for the impasse cluster randomized trial |
| topic | Asthma Self-management Telemanagement E-health Self-management Implementation Chronic care |
| url | http://www.implementationscience.com/content/7/1/113 |
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