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一项随机对照试验,旨在衡量初级保健临床医生向成年哮喘患者推广的数字社交干预措施在改善哮喘控制方面的有效性和成本效益:研究方案。

Randomised controlled trial to measure effectiveness and cost-effectiveness of a digital social intervention promoted by primary care clinicians to adults with asthma to improve asthma control: protocol.

作者信息

Karampatakis Georgios Dimitrios, Wood Helen E, Griffiths Chris J, Taylor Stephanie Jc, Toffolutti Veronica, Bird Victoria J, Lea Nathan C, Ashcroft Richard, Coulson Neil S, Panzarasa Pietro, Li Xiancheng, Sheikh Aziz, Relton Clare, Sastry Nishanth, Watson Jane S, Mant Jonathan, Marsh Viv, Day Bill, Mihaylova Borislava, Walker Neil, De Simoni Anna

机构信息

Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK

Centre for Applied Respiratory Research, Innovation and Impact, Queen Mary University of London, London, UK.

出版信息

BMJ Open. 2025 Sep 11;15(9):e104367. doi: 10.1136/bmjopen-2025-104367.

Abstract

INTRODUCTION

In the UK, approximately 5.4 million adults live with asthma, of whom one in five have an uncontrolled form. Uncontrolled asthma reduces quality of life and increases healthcare use. Engaging with peers through online health communities (OHCs) can empower patients to self-manage their long-term condition. While OHCs have been in existence for several years and growing numbers of patients access them, the role of primary care in signposting patients to them has been minimal and ad hoc. We have co-developed with patients and healthcare professionals (HCPs) an intervention for adult patients with asthma, consisting of an appointment with a primary care HCP to introduce online peer support and sign patients up to an established asthma OHC, followed by OHC engagement. Feasibility work found the intervention acceptable to patients and HCPs. This protocol outlines our plan to test the intervention's effectiveness and cost-effectiveness.

METHODS AND ANALYSIS

An individual randomised controlled trial will be carried out. Eligible participants will be recruited via an online survey sent to adult patients on the asthma register in 50-70 general practices in several UK locations. Participants will be invited to attend a one-off, face-to-face appointment with a primary care HCP, during which they will be individually randomised to the intervention or usual care. An asthma control test (primary outcome) and other measures of clinical effectiveness will be collected at baseline and every 3 months over a 12-month follow-up period. Descriptive and inferential statistics will be used to compare outcome measures between study arms. Cost-effectiveness assessment of the intervention compared with current standard of asthma management in primary care will be reported. A sample of patients and HCPs will be interviewed at study exit and the data analysed thematically.

ETHICS AND DISSEMINATION

The study was approved by a National Health Service Research Ethics Committee (reference: 25/NE/0006). Written consent will be obtained from all participants. Findings will be disseminated through various means, including sharing with general practices, conference presentations and peer-reviewed publications.

TRIAL REGISTRATION NUMBER

NCT06849245.

摘要

引言

在英国,约有540万成年人患有哮喘,其中五分之一的患者病情未得到控制。未得到控制的哮喘会降低生活质量并增加医疗保健的使用。通过在线健康社区(OHC)与同龄人互动可以使患者有能力自我管理其长期病情。虽然OHC已经存在了数年,并且越来越多的患者使用它们,但初级保健在将患者引导至这些社区方面所起的作用微乎其微且是临时的。我们与患者和医疗保健专业人员(HCP)共同开发了一种针对成年哮喘患者的干预措施,包括与初级保健HCP进行一次预约,以介绍在线同伴支持并让患者注册加入一个成熟的哮喘OHC,随后参与OHC活动。可行性研究发现该干预措施为患者和HCP所接受。本方案概述了我们测试该干预措施有效性和成本效益的计划。

方法与分析

将进行一项个体随机对照试验。符合条件的参与者将通过向英国多个地区50 - 70家全科诊所哮喘登记册上的成年患者发送在线调查问卷来招募。参与者将被邀请与初级保健HCP进行一次性面对面预约,在此期间他们将被单独随机分配到干预组或常规护理组。在基线时以及在12个月的随访期内每3个月收集一次哮喘控制测试(主要结局)和其他临床有效性指标。将使用描述性和推断性统计来比较研究组之间的结局指标。将报告该干预措施与初级保健中哮喘管理当前标准相比的成本效益评估。将在研究结束时对一部分患者和HCP进行访谈,并对数据进行主题分析。

伦理与传播

该研究已获得英国国家医疗服务体系研究伦理委员会批准(参考编号:25/NE/0006)。将获得所有参与者的书面同意。研究结果将通过多种方式传播,包括与全科诊所分享、在会议上展示以及在同行评审期刊上发表。

试验注册号

NCT06849245。

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