At-Risk Registers Integrated into primary care to Stop Asthma crises
Research type
Research Study
Full title
At-Risk Registers Integrated into primary care to Stop Asthma crises in the UK (ARRISA-UK): A pragmatic cluster randomised trial with nested economic and process evaluations examining the effects of integrating at-risk asthma registers into primary care with internet-based training and support
IRAS ID
161432
Contact name
Andrew M. Wilson
Contact email
Duration of Study in the UK
3 years, 11 months, 30 days
Research summary
Many UK asthma patients are admitted to hospital (approximately 72,000) or die (approximately 1,150) every year. Current treatments should allow asthma to be controlled in most patients. However certain asthma patients are at greater risk of being admitted or dying than others and intensive support of these patients may improve their health. This study will confirm we can improve the care of these patients, cost to the NHS, and the effect on care of other asthma patients.
We will recruit 262 GP practices and expect they will identify 9170 patients who are at risk of having severe asthma attacks. Half of the GP practices will be randomised to have a computerised alert message whenever any of the ‘at-risk’ patients make contact with anyone in the practice. Practice staff will be trained on what to do when they see the alert, for example, remind receptionists to book urgent appointments; GPs and nurses to advise patients to take their medication and follow their written asthma action plans (personalised documents which advise patients what to do when their asthma gets worse or better); and pharmacists to ensure patients take their medicines.
Routinely available anonymised data from patients will be collected from participating practices. Practices will be followed up for 12 months, after which we will count visits to Accident and Emergency, hospital admissions, and deaths due to asthma. We will also measure asthma control, medications prescribed, attendance for routine appointments and smoking cessation. We will calculate how much this costs and whether it improves (or interferes with) the care of other patients with asthma in the practices. With informed consent, we will arrange focus groups and interviews for patients and staff, to discuss thoughts about the at-risk registers, the training, and how it worked in practice.
REC name
Wales REC 4
REC reference
14/WA/1211
Date of REC Opinion
26 Nov 2014
REC opinion
Further Information Favourable Opinion