Montejo Marta, Paniagua Natalia, Sanchez Alvaro, Rueda-Etxebarria Mikel, Pijoan Jose I, Saiz Hernando Carlos, Martin Vanesa, Vázquez Ronco Miguel Angel, Santiago Burruchaga Mikel, García Urabayen Diego, Pérez Llarena Garbiñe, Castelo Susana, Benito Javier
San Vicente Health Centre, Barakaldo-Sestao Integrated Health Organization, Basque Health Service-Osakidetza, Barakaldo, Spain.
Paediatric Emergency Department, Ezkerraldea-Enkarterri-Cruces Integrated Health Organization, Cruces University Hospital, Basque Health Service-Osakidetza, Barakaldo, Spain.
Front Pediatr. 2025 Aug 19;13:1646499. doi: 10.3389/fped.2025.1646499. eCollection 2025.
This study aims to evaluate the effectiveness and feasibility of the implementation of an Asthma Integrated Care Pathway (AICP) to improve care and reduce variability according to recommended clinical practice guidelines, for children presenting with acute asthma episodes in paediatric primary care, and hospital services including emergency departments.
A cluster quasi-experimental implementation trial with a matched control group will be launched in a regional healthcare service. All the paediatric healthcare professionals providing care in two health districts (HDs) will receive interventions over two 12-month periods during which components of the implementation strategy to favour adoption of the AICP will be deployed cumulatively. A selected set of professionals from the same levels of care in the other HDs ( = 11) will serve as the comparison group. The target population of the AICP is children between 2 and 14 years old presenting with an acute asthma episode during the study period. A mixed methods evaluation guided by the RE-AIM framework will assess the effectiveness of the AICP after 12, 24, and 36 months in a set of pre-specified care and implementation outcomes at the professional level. The perceived feasibility of the AICP and its implementation from the perspective of physicians and the experience and satisfaction of patients concerning the clinical care received will be assessed through discussion groups.
This study performed in real-world settings will contribute in extending knowledge in asthma care pathways beyond emergency settings into primary care and across the healthcare continuum. In addition, its findings aim to guide health systems in reducing variability in care, increasing guideline adherence, and ultimately improving paediatric asthma outcomes across the system.
ClinicalTrials.gov, identifier [NCT06437444].
本研究旨在评估实施哮喘综合护理路径（AICP）的有效性和可行性，以根据推荐的临床实践指南改善护理并减少变异性，该指南适用于儿科初级护理中出现急性哮喘发作的儿童以及包括急诊科在内的医院服务。
将在一个区域医疗服务机构开展一项设有匹配对照组的整群准实验性实施试验。在两个健康区（HDs）提供护理的所有儿科医疗专业人员将在两个为期12个月的时间段内接受干预，在此期间将逐步部署有利于采用AICP的实施策略的各个组成部分。从其他HDs相同护理水平中挑选出的一组专业人员（n = 11）将作为对照组。AICP的目标人群是在研究期间出现急性哮喘发作的2至14岁儿童。由RE-AIM框架指导的混合方法评估将在12、24和36个月后，在专业层面的一组预先指定的护理和实施结果方面评估AICP的有效性。将通过讨论组评估从医生角度看AICP及其实施的可感知可行性，以及患者对所接受临床护理的体验和满意度。
这项在现实环境中进行的研究将有助于把哮喘护理路径的知识从急诊环境扩展到初级护理以及整个医疗连续体。此外，其研究结果旨在指导卫生系统减少护理变异性、提高指南依从性，并最终改善整个系统的儿科哮喘治疗效果。
ClinicalTrials.gov，标识符 [NCT06437444]
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