Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

man using an inhaler

This PCORI-funded implementation project is making a treatment approach for asthma, shown to reduce asthma attacks and improve asthma control, part of regular care in in four health systems across the country.

Asthma is a health problem that can make it hard to breathe. People with uncontrolled asthma may have to go to the emergency room or hospital when asthma attacks occur. Asthma attacks can also make doing normal activities like going to work or school difficult.

What is the goal of this implementation project?

As part of usual care for asthma, people with asthma often use a reliever inhaler with fast-acting medicine or a nebulizer to ease symptoms like wheezing. They also use an inhaled corticosteroid, or ICS, every day to help control their asthma and prevent asthma attacks.

A PCORI-funded research study with Black and Hispanic adults found that, compared with usual care alone, a treatment approach called Patient Activated Reliever-Triggered Inhaled CorticoSteroids, or PARTICS, reduced asthma attacks and improved asthma control. It also led to fewer missed days of work, school and doing usual activities. With PARTICS, people take a puff of ICS each time they need to take a puff of a rescue inhaler and five puffs of ICS each time they use a nebulizer.

This project is making PARTICS part of regular care at health systems in four states to improve outcomes for adult patients with moderate to severe asthma.

What will this project do?

The project team is working with four health systems in California, Colorado, Ohio, and Tennessee. These health systems serve diverse communities. Three of the health systems mainly serve patients who are Black, Hispanic, or without health insurance.

To make PARTICS part of regular asthma care for adults, the project team is:

  • Preparing and working with a clinician champion to promote use of PARTICS at each site
  • Promoting awareness of PARTICS to clinicians through regular meetings, emails, newsletters, and self-teaching materials
  • Adapting electronic health record, or EHR, systems to identify eligible patients and alert clinicians before and during visits that patients may benefit from PARTICS
  • Supporting prescribing through EHR systems at three of the four sites
  • Informing patients about PARTICS through letters, texts, or messages in their patient portal
  • Updating after-visit summaries for patients to include information about how to use PARTICS as well as links to educational videos
  • Providing reports every three to six months on the use of PARTICS by patients at each site

What is the expected impact of this project?

The project will demonstrate what’s required to make PARTICS part of regular care in health systems. These systems vary in size and serve diverse patients. More than 1,600 clinicians will learn about PARTICS. About 14,900 patients with asthma will receive PARTICS. The project evaluation will confirm that PARTICS is working as intended to improve outcomes for adult patients with asthma.

More about this implementation project:

Stakeholders Involved in This Project

  • American Academy of Allergy, Asthma, and Immunology
  • American Academy of Pediatrics
  • Allergy and Asthma Network
  • American College of Osteopathic Family Physicians
  • American Lung Association
  • Asthma and Allergy Foundation of America
  • Local implementation teams at each site, including patient partners, frontline clinicians, EHR programmers, and a local clinician champion

Implementation Strategies

  • Adapt sites’ EHR systems, working with EHR personnel, to include clinical decision supports, such as pop-up alerts and smartsets to alert providers when a patient would benefit from PARTICS
  • Adapt materials used in the original study, PREPARE, to meet each site’s needs
  • Provide sites with tools to support implementation, including EHR-integrated patient eligibility queries, prescribing modules, and patient instruction sheets
  • Support implementation teams at sites
  • Promote patient awareness of PARTICS through letters, text messages, and patient portal, working with each site’s patient advisors
  • Identify and prepare a physician champion at each site to lead clinician awareness through staff meetings, educational meetings, emails, and newsletters
  • Provide clinics with audit and feedback reports on the number of PARTICS prescriptions that are distributed and refused
  • Offer continuing medical education credits

Evaluation Outcomes

To document implementation:

  • Number and proportion of eligible patients prescribed PARTICS
  • Number and proportion of patients prescribed PARTICS who fill at least one prescription
  • Number and proportion of EHR alerts that clinicians acted on
  • Adoption (i.e., number and proportion of clinicians who started at least one patient on PARTICS)
  • Fidelity to treatment approach
  • Maintenance of intervention components by site and patients

To assess healthcare and health outcomes:

  • Asthma exacerbation rates from EHR and claims data
  • Decreased emergency department visits and hospitalizations if available through EHR

Project Information

Elliot Israel, M.D.
Partners Healthcare Brigham and Women's Hospital
$2,070,001
Implementation of Patient Activated Reliever-Triggered Inhaled Corticosteroids in Adults with Moderate to Severe Asthma

Key Dates

March 2023
June 2026
2023

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Comparing Ways to Decrease Severe Asthma Attacks among Black and Latinx Adults with Moderate to Severe Asthma -- The PREPARE Study

Tags

State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 12, 2024