CHEST: A Collaboration With Community HEalth Centers to Implement SmarT for Asthma

Inclusion Criteria19

• The study population can be viewed from the cluster (clinic), clinician, staff, or patient level.
• At the cluster (clinic) level: To be eligible to participate in this study, a cluster (clinic) must meet all the following criteria:
• Active participation in the St. Louis Integrated Health Center Network for Community Academic Partnerships.
• Employment of at least 3 clinicians who commonly manage adult asthma (defined as managing asthma for at least one adult asthma patient, on average, on a weekly basis).
• Data provided to Azara for data queries, and
• Willing and able to receive all components of the SMART implementation bundle (i.e., initial educational outreach visit, ongoing practice facilitation/supervision, audit \& feedback, and provision of education of patient-level education aides and SMART asthma action plans and monthly operations committee meetings).
• At the clinician/clinical staff level:
• To be eligible to participate in this study, a clinician/clinical staff member must meet all of the following criteria:
• Provision of a signed and dated informed consent form.
• Current state licenses of physician, assistant physician, nurse practitioner, or physician assistant.
• Regularly cares for adults with asthma (which may include those trained in family medicine, internal medicine, obstetrics/gynecology, and/or specialty medicine).
• Willing and able to integrate the SMART implementation bundle into their practice.
• Willing and able to participate for the entire duration of the study, including the pre-implementation, active implementation, and post-implementation periods.
• Willing to provide data on prescribing patterns and asthma patient outcomes for the duration of the study.
• At the patient level:
• To be eligible to participate in this study, a patient must meet all of the following criteria:
• Age ≥12 years old
• Diagnosis of asthma, of any severity, coded (i.e., International Classification of Diseases \[ICD\]-10-CM: J45\*\*).
• The patient has had ≥2 asthma exacerbations in the last year during which systemic corticosteroids were prescribed, and/or the encounter contains an active prescription for an inhaler that is congruent with medium-dose (or higher) maintenance inhaled corticosteroids (ICS) inhalers or low-dose (or higher) ICS-long-acting β-agonist (LABA) inhalers with concomitant reliever short-acting β-agonist inhalers.