NCT02316223

Brief Summary

A 3-arm, patient-randomized trial among Latino and African-American older adults with poorly-controlled asthma will be conducted to compare the effectiveness of clinic-based vs. home-based asthma care coordination / self-management support (CC/SMS) vs. usual care.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
406

participants targeted

Target at P75+ for not_applicable asthma

Timeline
Completed

Started Jan 2015

Typical duration for not_applicable asthma

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 10, 2014

Completed
2 days until next milestone

First Posted

Study publicly available on registry

December 12, 2014

Completed
20 days until next milestone

Study Start

First participant enrolled

January 1, 2015

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 2, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 2, 2018

Completed
3.7 years until next milestone

Results Posted

Study results publicly available

October 6, 2021

Completed
Last Updated

October 6, 2021

Status Verified

September 1, 2021

Enrollment Period

3.1 years

First QC Date

December 10, 2014

Results QC Date

December 10, 2018

Last Update Submit

September 9, 2021

Conditions

Keywords

asthmahigh-riskadultelderlycare coordinationcommunity health workerelectronic medical record

Outcome Measures

Primary Outcomes (1)

  • Change in Asthma Control Test (ACT)

    The Asthma Control Test™ is a quick test for people with asthma 12 years and older. The ACT is a 5 items, with 4-week recall (on symptoms and daily functioning) patient self-administered tool for identifying those with poorly controlled asthma. Each items is scored on a 5-point scale (for symptoms and activities: 1=all the time to 5= not at all; for asthma control rating: 1=not controlled at all to 5=completely controlled), The total scores range from 5 (poor control of asthma) to 25 (complete control of asthma), with higher scores reflecting greater asthma control. It provides a numerical score to help assess asthma control at 12 months compared to baseline.

    baseline, 3 months, 6 months, and 12 months

Secondary Outcomes (4)

  • Mini Asthma Quality of Life Questionnaire (AQLQ)

    baseline, 3 months, 6 months, and 12 months

  • Change in Percent of Patients With >=1 Emergency Dept Visits

    12 months

  • Medication Adherence Rating Scale (MARS)

    baseline, 3 months, 6 months, and 12 months

  • Number of Participants With Correct MDI Technique

    baseline and 12 months

Study Arms (3)

Clinic-based care coordination

EXPERIMENTAL

The ACC and CHW programs for asthma CC/SMS will have the same objectives and provide the same general services at the office/clinic. The ACC and CHW programs were developed from existing, successfully operating programs at the participating sites, and in the East Harlem and South Bronx communities.

Behavioral: Supporting Asthma Management Behaviors in Aging Adults (SAMBA)

Home-based care coordination

ACTIVE COMPARATOR

The ACC and CHW programs for asthma CC/SMS will have the same objectives and provide the same general services at participant's home. The ACC and CHW programs were developed from existing, successfully operating programs at the participating sites, and in the East Harlem and South Bronx communities.

Behavioral: Supporting Asthma Management Behaviors in Aging Adults (SAMBA)

Usual care

NO INTERVENTION

Clinician-centric strategy and EMR-based clinician decision support

Interventions

The SAMBA program will be led by an asthma care coach (ACC) and the home program by a community health worker (CHW). All interventions, including usual care, will include EMR-based asthma self-management and decision support tools for clinicians in all practice sites. The ACC and CHW will provide education, goal setting, and general self-management support with assigned patients and coordinate with PCPs through in-person and phone contacts over 12 months. Outcomes will be measured through interviews, EMR chart abstractions, and from the Statewide Planning and Research Cooperative System (SPARCS) dataset to identify all ED visits and hospitalizations to any New York State facility.

Also known as: SAMBA
Clinic-based care coordinationHome-based care coordination

Eligibility Criteria

Age60 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ages ≤60 years
  • physician diagnosis of asthma
  • English- or Spanish-speaking

You may not qualify if:

  • physician diagnosis of Chronic Obstructive Pulmonary Disease (COPD) or other chronic lung condition
  • ≤15 pack-years
  • enrollment in another asthma self-management program

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

The Institute for Family Health

New York, New York, 10003, United States

Location

Mount Sinai-St. Luke's Roosevelt Hospital Center

New York, New York, 10025, United States

Location

Icahn School of Medicine at Mount Sinai

New York, New York, 10029, United States

Location

Related Publications (2)

  • Federman AD, Thanik E, O'Conor R, Arora A, Wolf MS, Wisnivesky JP. Patient characteristics associated with improvements in asthma control and reduction in emergency department visits for older adults with asthma. J Asthma. 2021 Nov;58(11):1528-1535. doi: 10.1080/02770903.2020.1805753. Epub 2020 Aug 19.

  • Federman AD, O'Conor R, Mindlis I, Hoy-Rosas J, Hauser D, Lurio J, Shroff N, Lopez R, Erblich J, Wolf MS, Wisnivesky JP. Effect of a Self-management Support Intervention on Asthma Outcomes in Older Adults: The SAMBA Study Randomized Clinical Trial. JAMA Intern Med. 2019 Aug 1;179(8):1113-1121. doi: 10.1001/jamainternmed.2019.1201.

MeSH Terms

Conditions

Asthma

Condition Hierarchy (Ancestors)

Bronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System Diseases

Results Point of Contact

Title
Dr. Alex Federman
Organization
Icahn School of Medicine at Mount Sinai

Study Officials

  • Alex Federman, MD,MPH

    Icahn School of Medicine at Mount Sinai

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 10, 2014

First Posted

December 12, 2014

Study Start

January 1, 2015

Primary Completion

February 2, 2018

Study Completion

February 2, 2018

Last Updated

October 6, 2021

Results First Posted

October 6, 2021

Record last verified: 2021-09

Locations