Recruiting

SMART Implementation-Effectiveness Trial 2

While single maintenance and reliever therapy (SMART) has been the preferred management strategy for Step 3 and 4 (moderate/severe) asthma management since the 2020 NIH asthma guideline updates, adoption of SMART has not been rigorously assessed. This study will test population health management (PHM; asthma community health worker, asthma nurse care manager) implementation strategies building on electronic medical record clinical decision support and education implementation strategies (CDS+), to increase…

ClinicalTrials.gov IDNCT07138027

PhaseNA

Enrollment18

SponsorChildren's Hospital of Philadelphia

Age5 Years

SexALL

I'm interested View official listing

Conditions studied

Asthma in Children

About this study

Interventions

Behavioral: Clinical decision support + education (CDS+) and population health management (PHM) — In Interval 1, intervention clinic providers will experience nudges in the electronic medical record to encourage prescribing SMART where clinically-appropriate and intervention clinic providers, families/patients, and nurses will receive education (collectively CDS+). In Interval 2, intervention clinics will have CDS+ and population health management (PHM) strategies, including an asthma community health worker and an asthma nurse care manager.
Other: Control — Clinics in Arm 2 will not be exposed to the interventions.

Primary outcomes

Change in the Rate of Visit-Level SMART Adoption (Assessment of rates from two study intervals: Interval 1 (CDS+; 11 months), Interval 2 (CDS+ and PHM; 11 months). There will be a one month ramp up period at the start of each study interval (ramp up period data will not be included in analyses).)

Eligibility information

Clinic Inclusion Criteria: * The clinic is a pediatric primary care clinic that is part of the Children's Hospital of Philadelphia (CHOP) Pediatric Research Consortium (PeRC). * The clinic agrees to participate in SMART \& SIMPLE study. Patient Inclusion Criteria: * Ages 5-18 years; * Has clinic visit at participating practice during study interval (sick, well, or follow-up) * Prescribed at least one prescription for an inhaled corticosteroid (ICS) or ICS-long-acting beta agonist (ICS-LABA) for maintenance asthma therapy in the past year; * Evidence of uncontrolled asthma as determined by: (1) uncontrolled Asthma Control Tool score in the past 6 months OR (2) two or more systemic corticosteroids prescribed for an asthma exacerbation in the past 12 months (one occurring in the past 6 months) Clinic Exclusion Criteria: \- The clinic is not willing to participate in SMART \& SIMPLE study interventions. Patient Exclusion Criteria: \- Transferred clinics or left the CHOP Pediatric Care Network.

Study locations

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 United States

Before you participate: Varda Clinical is an independent discovery tool, not the study sponsor or a medical provider. Eligibility can only be determined by the official study team. Discuss potential risks and benefits with a qualified healthcare professional.

Source: ClinicalTrials.gov. Record last refreshed by Varda Clinical: 2026-09-27.