eAMS-Eco: Implementation of a Tool for Climate Conscious Inhaler Prescribing

NCT07638735 | Enrolling By Invitation

• 1 other identifier: 25-271
• Study Type: interventional
• Target: 95
• Locations: 1 country
• Sites: 4

Brief Summary

The goal of this study is to determine whether an 'eco' version of the Electronic Asthma Management System (eAMS) can reduce inhaler carbon emissions in primary care, in patients with asthma. The existing eAMS uses patient-specific criteria (asthma control, asthma flare-up risk, and current medications) to provide guideline-based computerized clinical decision support to clinicians, to improve the delivery of asthma care. The eAMS-Eco includes embedded cues and messaging on the environmental impact of inhaler medications and links to a patient-friendly conversation aid that facilitates shared decision-making and climate-conscious prescribing. The study will evaluate the implementation of the eAMS-Eco in four primary care clinics that have been using the existing eAMS, using an interrupted time-series analysis (one year pre- and post-launch of the eAMS-Eco). The investigators will assess system uptake and user feedback on the eAMS-Eco, as well as changes in inhaler prescriptions (including resulting changes in carbon emissions and costs) and changes in asthma control, in the implementation period (eAMS-Eco) compared to the baseline period (eAMS).

Conditions

Asthma; Primary Care; Asthma Management; Computerized Decision Support System

Keywords

Electronic Asthma Management System (eAMS); Computerized Decision Support System (CDSS); Asthma; Asthma Management

Outcome Measures

Primary Outcomes (2)

• Prescribed inhaler carbon emissions

  Among patients entering on at least one metered dose inhaler, system analytics, chart review and existing data on inhaler carbon emissions will be used to assess the average and total difference in the change (exit versus entry medications) in estimated annual carbon emissions from inhalers per patient between the baseline and implementation periods

  24 months, cumulative and broken into individual time periods

• Proportion of low carbon footprint inhalers to moderate/high carbon footprint inhalers prescribed

  For all new inhaler prescriptions, system analytics and chart review data will be used to compare the difference in the average proportion of low to moderate/high carbon footprint inhalers across all patients, between the baseline and implementation periods

  24 months, cumulative and broken into individual time periods

Secondary Outcomes (10)

• Cost of prescribed inhalers

  24 months, cumulative and broken into individual time periods

• System usage: conversation aid access

  12 months, cumulative and broken into individual time periods

• System usage: decision-support access

  24 months, cumulative and broken into individual time periods

• Quantitative patient Likert-Scale questionnaire

  12 months

• Patient feedback: 4-item Shared Decision-Making Process Scale

  12 months

Study Arms (2)

Electronic Asthma Management System (eAMS)

NO INTERVENTION

A retrospective chart review and system audit will assess outcomes during the one-year baseline period where the base version of the Electronic Asthma Management System (eAMS) was in use

eAMS-Eco

ACTIVE COMPARATOR

The eAMS-Eco will be launched at study sites and available to clinicians to use for eligible patients with data collected prospectively for 12 months

Behavioral: Climate-Conscious Clinical Decision Support System for Asthma Management

Interventions

Climate-Conscious Clinical Decision Support System for Asthma Management BEHAVIORAL

An 'eco' version of a computerized clinical decision support system that provides information on the carbon footprint of inhalers when making guideline-based treatment recommendations for patients with asthma

Also known as: eAMS-Eco

eAMS-Eco

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Active clinician at one of the four study sites during the study period
• Patient eligibility criteria:
• Patient at one of the four study sites with a visit during the study period
• Diagnosis of asthma (using validated algorithm for primary care of
• asthma billing code (493) in the past 3 years OR asthma in the cumulative patient profile (CPP) and
• prescription for an inhaler in the past year

Sponsors & Collaborators

• University of Toronto: lead

Study Sites (4)

Taddle Creek Family Health Team (Bay Street)

Toronto, Ontario, M5G 1N8, Canada

Location

Sinai Health Family Health Team (Toronto Site)

Toronto, Ontario, M5T 3L9, Canada

Location

Taddle Creek Family Health Team (Bloor Street)

Toronto, Ontario, M6G 4A1, Canada

Location

Sinai Health Family Health Team (Vaughan Site)

Vaughan, Ontario, L6A 3Z8, Canada

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 Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Interrupted Time Series Analysis

Study Record Dates

• First Submitted: May 27, 2026
• First Posted: June 10, 2026
• Study Start: April 28, 2026
• Primary Completion (Estimated): April 28, 2027
• Study Completion (Estimated): July 7, 2027
• Last Updated: June 10, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (4)