PCORI implementation projects promote the use of findings from PCORI-funded studies. This project focuses on implementing findings from the completed PCORI-funded research project: Training Staff at Doctors’ Offices to Use Shared Decision Making with Patients Choosing Asthma Treatments.
This project is in progress.
What were the results from the original PCORI-funded research study?
In shared decision making, or SDM, patients work with their doctors to select tests and treatments based on what is most important to them. The PCORI-funded research study compared different ways to help primary care practices use SDM with patients who have asthma. In one approach, a coach helped staff learn how to support SDM. In another, staff learned about SDM in a lunch-and-learn session. Practices with a coach had more patients who said they shared equally in treatment decisions.
Why is this research finding important?
Asthma is a chronic lung disease that affects more than 26 million people, including 6.2 million children. Patients and doctors can manage asthma with primary care visits. But when it is not well-controlled, asthma can lead to hospitalizations and even death. Studies have shown that SDM can help patients manage their asthma, but SDM isn’t always part of care. This study found that coaching was an effective way to support SDM that improved patients’ involvement with their asthma treatment decisions. However, it also found that some practices lacked the time or the staff to use the coaching approach.
What is the goal of this project?
Some patients who have trouble managing asthma go to the emergency room, or ER, for treatment rather than to primary care practices. This project is applying the findings and lessons learned from the PCORI study in primary care practices to help children who come to the ER for care.
What is the project team doing?
The project team adapted the asthma shared decision program to a virtual iPad format, called Asthma Coach. Children can use this program with their parents in the ER to help make choices about the treatment they will have after they go home. Asthma Coach uses an animated computer character to create a personalized shared treatment decision. The project team is training clinicians and staff at two pediatric ERs—in Charlotte, North Carolina, and Atlanta, Georgia—to use Asthma Coach as part of the care they provide to children who have asthma.
How is the team evaluating this project?
The project team is tracking how often patients and hospital staff use Asthma Coach and whether patients are more involved in treatment decisions when using the app. The team is also tracking patients’ return visits to the hospital or to the ER, and their use of asthma medications.
How is the project team involving patients and others in making sure the findings reach people who can use them?
The team is working with ER doctors and staff, the Asthma and Allergy Foundation of America, healthcare systems in the southeast, local and national advocacy groups, and policy advisors such as the Mecklenburg County Asthma Coalition. These partners will help to train ER clinicians and staff, help solve problems in implementing Asthma Coach, and raise awareness of using SDM in the ER to improve outcomes for patients.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.