Morrison Deborah, Wyke Sally, Thomson Neil C, McConnachie Alex, Agur Karolina, Saunderson Kathryn, Chaudhuri Rekha, Mair Frances S
General Practice & Primary Care, 1 Horselethill Road, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 9LX, UK.
Trials. 2014 May 24;15:185. doi: 10.1186/1745-6215-15-185.
The financial costs associated with asthma care continue to increase while care remains suboptimal. Promoting optimal self-management, including the use of asthma action plans, along with regular health professional review has been shown to be an effective strategy and is recommended in asthma guidelines internationally. Despite evidence of benefit, guided self-management remains underused, however the potential for online resources to promote self-management behaviors is gaining increasing recognition. The aim of this paper is to describe the protocol for a pilot evaluation of a website 'Living well with asthma' which has been developed with the aim of promoting self-management behaviors shown to improve outcomes.
METHODS/DESIGN: The study is a parallel randomized controlled trial, where adults with asthma are randomly assigned to either access to the website for 12 weeks, or usual asthma care for 12 weeks (followed by access to the website if desired). Individuals are included if they are over 16-years-old, have a diagnosis of asthma with an Asthma Control Questionnaire (ACQ) score of greater than, or equal to 1, and have access to the internet. Primary outcomes for this evaluation include recruitment and retention rates, changes at 12 weeks from baseline for both ACQ and Asthma Quality of Life Questionnaire (AQLQ) scores, and quantitative data describing website usage (number of times logged on, length of time logged on, number of times individual pages looked at, and for how long). Secondary outcomes include clinical outcomes (medication use, health services use, lung function) and patient reported outcomes (including adherence, patient activation measures, and health status).
Piloting of complex interventions is considered best practice and will maximise the potential of any future large-scale randomized controlled trial to successfully recruit and be able to report on necessary outcomes. Here we will provide results across a range of outcomes which will provide estimates of efficacy to inform the design of a future full-scale randomized controlled trial of the 'Living well with asthma' website.
This trial is registered with Current Controlled Trials ISRCTN78556552 on 18/06/13.
与哮喘护理相关的财务成本持续增加,而护理效果仍不理想。促进最佳自我管理,包括使用哮喘行动计划,以及定期接受医疗专业人员的评估,已被证明是一种有效的策略,并且在国际哮喘指南中得到推荐。尽管有证据表明其益处,但指导性自我管理的应用仍然不足,不过在线资源促进自我管理行为的潜力正日益得到认可。本文的目的是描述一个针对“哮喘良好生活”网站的试点评估方案,该网站旨在促进已被证明能改善治疗效果的自我管理行为。
方法/设计:该研究是一项平行随机对照试验,患有哮喘的成年人被随机分配为要么访问该网站12周,要么接受为期12周的常规哮喘护理(如果愿意,之后可访问该网站)。如果个体年龄超过16岁,被诊断为哮喘且哮喘控制问卷(ACQ)得分大于或等于1,并且能够访问互联网,则纳入研究。此次评估的主要结果包括招募率和保留率、ACQ和哮喘生活质量问卷(AQLQ)得分在12周时相对于基线的变化,以及描述网站使用情况的定量数据(登录次数、登录时长、各个页面的查看次数以及查看时长)。次要结果包括临床结果(药物使用、医疗服务使用、肺功能)和患者报告的结果(包括依从性、患者激活指标和健康状况)。
对复杂干预措施进行试点被认为是最佳实践,这将使未来任何大规模随机对照试验成功招募并报告必要结果的潜力最大化。在此,我们将提供一系列结果,这些结果将提供疗效估计,为未来对“哮喘良好生活”网站进行全面随机对照试验的设计提供参考。
该试验于2013年6月18日在当前对照试验ISRCTN78556552上注册。