iCARE is a study comparing to effective asthma strategies, SMART vs. PARTICS
Background: Asthma affects as many as 262 million people worldwide, including over 25 million in the US. There are an estimated 136 million asthma exacerbations globally per year, including more than 10 million in the US.
US National Guidelines now recommend that inhaled corticosteroid be used with a reliever inhaler in addition to underlying therapy in most forms of asthma to reduce exacerbations, ICS inhaler every time a SABA is used for Step 2, ICS/formoterol as maintenance and reliever for Steps 3 and 4. This was based on studies of SMART (Single Maintenance And Reliever Therapy) studies that primarily used budesonide-formoterol (Symbicort) as both the reliever and maintenance therapy
These studies, in moderate-severe asthma, showed 0.12 exacerbation/yr reduction in exacerbations (30% reduction), an average >4 extra Symbicort inhalers a year above background Symbicort in the intervention group as c/w the control using background Symbicort and albuterol, there was generally not an improvement in symptoms.
However, SMART studies excluded patients who used a nebulizer as a reliever since they would not be permitted to take extra Symbicort when using nebulizer relievers, required changing the underlying medication to Symbicort and In the USA additional SMART use is specifically warned against by the FDAdue to the FDA warning and refill policies insurance will frequently not cover 2 dispenses of Symbicort a month required for the background and the reliever.
The PREPARE study tested PARTICS – Patient Activated Reliever Triggered ICS, an add-on therapy instructing patients puff of ICS for a puff of reliever whenever using a reliever inhaler or 5 puffs of ICS whenever using a nebulizer for reliever. PREPARE included nebulizer users and found they are more likely to have, Severe Exacerbation in prior 12 months: 85% vs 62% (p < 0.001), ED visits (70% vs. 50%; p < 0.001), at least 1 hospitalization (30% vs 10%; p < 0.001), lower asthma control 13 vs. 16, lower quality of life scores, 0.60 vs. 0.72, greater number of comorbid conditions and were disabled, less likely to be working for pay.
Patient Eligibility:
Site Procedures:
When will we be involved?
Compensation
Consider being a part of EquiP-PC!
The Equitable Primary Care for Pain Care (EquiP-PC) study is a pragmatic, multi-site, 3-arm cluster randomized controlled trial (RCT) focused on improving care for adults living with chronic pain.
Our goal: To strengthen Integrated Behavioral Health (IBH) services in primary care and help
practices deliver more effective, equitable, and comprehensive care for patients with chronic pain.
Participating practices will benefit from:
Specialized training for behavioral health professionals in Cognitive Behavioral Therapy (CBT) and Exercise Therapy (ET) tailored specifically for chronic pain management
Integration of evidence-based digital therapeutic apps to enhance patient engagement and self-management
Support for coordinated, multidisciplinary care that addresses the physical, emotional,
and social dimensions of chronic pain
What will we do?
To support implementation, we’ve developed a chronic pain care toolkit designed for behavioral health professionals working within primary care. This toolkit has been tested in prior studies and shown to be both usable and effective in real-world primary care settings.
What?
The Practice-Empowered coloRectal Cancer Screening (PERCS) study is an NIH-funded study comparing different practice-based quality improvement (QI)strategies to increase colorectal cancer screening (CRC) among patients aged 45-75 who need screening.
Why?
We are conducting this study because patients who remain unscreened are at increased risk of invasive colon cancer and increased mortality. Evidence is needed to inform how best to implement CRC screening in primary care clinics to optimize equitable screening and clinical outcomes.
Practices Will…
BENEFITS FOR YOUR ORGANIZATION
PATIENTS