RECRUITING Phase 4 ClinicalTrials.gov

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

Sponsor: Washington University School of Medicine • ClinicalTrials.gov ID: NCT07241117

Registry updated: 2026-09-10

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Description

Purpose: This study aims to improve asthma care by helping clinicians at community health centers prescribe a guideline-recommended treatment called SMART (Single Maintenance and Reliever Therapy). The investigators will provide training and resources to clinicians, give feedback on prescribing patterns, and offer educational tools for patients and providers. The investigators will roll out these resources in stages across clinics. The study will measure how well the program helps clinicians prescribe SMART therapy and whether it reduces asthma exacerbations in patients.

Interventions

Implementation bundle (Behavioral)
The intervention is a SMART implementation bundle delivered in Federally Qualified Health Centers. Unlike drug trials, no medication is supplied; providers prescribe according to guidelines. The bundle includes four components: (1) clinician education with practice facilitation, (2) audit and feedback on prescribing, (3) workflow integration support, including prescribing preferences, and (4) patient education tools such as a SMART-aligned asthma action plan and videos tailored for low health literacy

Eligibility criteria

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: (1) Clinics within participating health systems (Affinia Healthcare and Family Care Health Centers) will be considered eligible if they provided care to ≥100 patients aged ≥12 years with asthma (ICD-10-CM: J45.xx) during the calendar year preceding implementation (2024). At the clinician level: Clinicians will be considered eligible if they: 1. are physicians, nurse practitioners, or physician assistants; 2. are actively employed at a participating clinic during the implementation period; and 3. provided care to ≥10 patients aged ≥12 years with asthma (ICD-10-CM: J45.xx) during the 12 months preceding implementation. At the staff level: Staff will be considered eligible if they: 1. are actively employed at a participating clinic during the implementation period; and 2. directly support clinical care delivery for patients aged ≥12 years with asthma. At the patient level: Patients will be considered eligible if they: 1. are aged ≥12 years; 2. received care at a participating clinic during the implementation period; and (3) meet the study-defined definition of moderate-to-severe asthma based on diagnosis codes, medication use, and/or exacerbation history as defined in the study protocol.

Conditions

Moderate to Severe Asthma

Locations

Affinia healthcare, 2220 Lemp Ave — St Louis, Missouri, United States
Affinia healthcare, 1717 Biddle Street — St Louis, Missouri, United States
Affinia healthcare, 4414 North Florissant Avenue — St Louis, Missouri, United States
Family Care Heath Center, 4352 Manchester Ave — St Louis, Missouri, United States
Washington University in St. Louis School of Medicine — St Louis, Missouri, United States
Family Care Heath Center, 401 Holly Hills Ave — St Louis, Missouri, United States
Affinia healthcare, 3396 Pershall Road, — St Louis, Missouri, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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