Can Education for South Asians With Asthma and Their Clinicians Reduce Unscheduled Care? A Randomised Trial

NCT00214669 | Completed Phase 1

• 2 other identifiers: CG-09-05-IHS04/060
• Study Type: interventional
• Target: 375
• Locations: 1 country
• Sites: 1

Brief Summary

People from ethnic minority groups suffer worse ill-health from asthma than those from majority groups. No studies have reduced emergency care for people from minority groups. We have developed an education programme to address barriers to improved care for south Asian people with asthma. The study is set in Tower Hamlets and Newham - the UK's most deprived and ethnically diverse boroughs. We will invite all the local GP practices to take part, and using a computer programme, randomised them (like tossing a coin) into two groups - a group receiving usual care and a group receiving our educational programme. This comprises:

• Education for specialist nurse and GPs and practice nurses, using our adaptation of an American education course, designed to improve shared-decision making, goal-setting and patient-clinician partnership.
• Lay-led 'expert-patient' education in small groups for patients, using an adaptation of another American course.
• Improved follow-up in primary care through appointment-booking by the specialist nurse.We will invite south Asians aged 3-65 years with asthma after A\&E attendance or hospital admission to take part. Those registered with practices receiving the educational programme will see the trial specialist nurse in a nurse-run clinic, where the nurse:
• provides self-management advice and a treatment plan,
• makes a follow-up appointment in primary care
• makes an appointment for lay-led 'expert-patient' sessions.Patients registered with 'usual care' practices receive usual care.

Conditions

Asthma

Keywords

ethnicity; primary care; education

Outcome Measures

Primary Outcomes (1)

• Primary outcomes are time to first unscheduled contact with acute asthma, and proportion of participants with unscheduled care, assessed from patient records 12 months after recruitment.

  12 months following recruitment date

Secondary Outcomes (1)

• Secondary outcomes are generic (EQ5D) and disease specific quality of life (AQ20 and North of England scales), prescribing and costs.

  12 months following recruitment date

Study Arms (2)

1

EXPERIMENTAL

Education for intervention specialist nurse and GPs and practice nurses from intervention practices, using our adaptation of Clarke's self-regulation education programme, designed to improve shared-decision making, goal-setting and patient-clinician partnership. Lay-led 'expert-patient' education in small groups for patients, using an adaptation of Lorig's chronic disease self-management programme. Improved follow-up in primary care through appointment-booking by the specialist nurse.

Behavioral: PACE (Professional Asthma Care Education); Behavioral: Lay Led Expert Patient Programme; Behavioral: Asthma self management education by a specialist nurse

2

NO INTERVENTION

Usual Care

Interventions

PACE (Professional Asthma Care Education) BEHAVIORAL

Education for intervention specialist nurse and GPs and practice nurses from intervention practices, using our adaptation of Clarke's self-regulation education programme, designed to improve shared-decision making, goal-setting and patient-clinician partnership.

1

Lay Led Expert Patient Programme BEHAVIORAL

Lay-led 'expert-patient' education in small groups for patients, using an adaptation of Stanford University's chronic disease self-management programme.

Also known as: Expert Patient Programme

1

Asthma self management education by a specialist nurse BEHAVIORAL

asthma education and self management, asthma action plans

1

Eligibility Criteria

• Age: 3 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Recent hospital attendance (A\&E, admitted) with uncontrolled asthma
• or recent out of hours (GP service) walk in centre attendance with uncontrolled asthma
• South Asian ancestry (Bangladeshi, Indian, Pakistani, Sri Lankan)
• registered with a GP in Newham or Tower Hamlets

You may not qualify if:

• patients not of South Asian origin
• aged under 3 years
• not currently registered with a local GP
• physician diagnosis of pure COPD
• patients unable to give informed consent

Sponsors & Collaborators

• Barts & The London NHS Trust: lead
• Asthma UK: collaborator
• Social Action for Health: collaborator
• Department of Health (Service Support - host acute/community): collaborator
• Noreen Clarke, Professor of Public Health, Michigan University: collaborator

Study Sites (1)

Barts and TheLondon, Queen Marys's School of Medicine and Dentistry

London, E1 4NS, United Kingdom

Location

MeSH Terms

Conditions

Asthma

Condition Hierarchy (Ancestors)

Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases

Study Officials

• Chris Griffiths, MB BS, DPhil

  Queen Mary's School of medicine and Dentistry

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 14, 2005
• First Posted: September 22, 2005
• Study Start: November 1, 2005
• Primary Completion: April 1, 2008
• Study Completion: April 1, 2009
• Last Updated: November 5, 2024

Record last verified: 2024-11

Locations

GB (1)