Εffectiveness of a Digital Social Intervention in Primary Care

NCT ID: NCT06849245

Last Updated: 2025-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-25

Study Completion Date

2027-12-31

Brief Summary

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The goal of this study is to deliver a definitive randomised controlled trial to measure the effectiveness and assess cost-effectiveness of a digital social intervention for patients with asthma, composed of promoting engagement with online peer support in a primary care consultation, followed by engagement with online peer support for 12 months. The main questions/objectives this study aims to answer/address are:

* Does promoting engagement with an online health community in primary care help people with troublesome asthma to experience fewer asthma symptoms?
* To assess cost-effectiveness of the intervention (including quality of life, well-being, use of healthcare services etc); stakeholder satisfaction (patients and healthcare professionals) with the intervention; fidelity of protocol delivery; context in which positive outcomes can be triggered.

Detailed Description

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Patients with troublesome asthma, from 50-70 UK general practices, who might consider seeking advice online will be identified through a short online survey. The survey will include an asthma control test (ACT) questionnaire, a question about the network of support they have with their asthma, whether they are members of another existing online health community and whether they would be interested in taking part in a research study involving engagement in an asthma online health community (if randomised to the intervention arm).

Patients meeting the eligibility criteria will be asked to attend a one-to-one consultation with a healthcare professional at their general practice, who will randomise them using a randomisation tool and subsequently deliver the intervention encouraging them to engage with the asthma online health community or provide usual primary care, respectively. Participants of the intervention arm will be given a username and password for the Asthma + Lung UK online health community and shown how to login to the online health community. Participants will be asked to complete an online questionnaire at this consultation and again 12 months later. The consultation should take 30-45 minutes and completing the data-collection questionnaire 12 months later should take around 10 minutes.

During the 12-month period after the consultation, patients will be phoned by members of the research team every 3 months to collect data through an ACT questionnaire as well as volume of asthma exacerbations and associated healthcare utiilisation (primary and secondary care attendances) within last 3 months. Monthly text messages will also be sent to participants in the intervention arm who have consented, reminding them to engage with the online health community. The final follow-up questionnaire will include questions about how well their asthma is controlled, anxiety and depression, taking their asthma medication, and quality of life. Subject to participants' consent, the investigators will also endeavour to extract data from healthcare records about asthma exacerbations and use of primary and secondary care health services during the 12-month follow-up period (for both control and intervention arm participants). This data will be obtained from 'Discovery' for practices in North-East London. 'Discovery' is a clinical partnership project in East London, run by the Clinical Effectiveness Group at Queen Mary University of London and setting out to link primary and secondary care records, by creating a single database. The Clinical Effectiveness Group extracts data in an anonymised format. For practices in other parts of the UK, NHS Digital will be used to obtain data from healthcare records, and respective protocols and policies will be followed.

Data on intervention arm participants' use of the Asthma + Lung UK OHC during the study period will be collected and analysed, subject to consent, including the amount of engagement (number of days, hours/day etc.), community/ies joined, number of logins, number of likes, and time spent on pages, as well as the content of any public posts made by participants (private messages sent on the OHC will not be accessed or analysed).

At the end of the 12-month follow-up period, one-to-one interviews will be carried out with approximately 25 of the participating patients and approximately 15 of the HCPs involved in the study. Exact numbers will be determined by the point of data saturation being reached, with further interviewees being recruited if necessary. A convenience sample of participants will be invited (by email/text/phone) to take part in this one-off interview, which will last around one hour. Interviews will be carried out by a member of the research team and take place remotely via an appropriate online platform (Zoom or Microsoft Teams). During the interview, participants will be asked a series of questions (from a pre-determined list) exploring their views about their involvement in the study. Interviews will be audio recorded (after securing participants' consent - relevant field in the consent form) for subsequent analysis.

Conditions

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Asthma Intermittent, Uncontrolled

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A general practice-based healthcare professional will carry out the study-related consultation (see 'Arms and Interventions' section below) and randomise participants to either the intervention or control group. Healthcare professionals will open a separate REDCap database to obtain the (automatically-generated) group assignment for the patient - either intervention or control - and will deliver the rest of the consultation accordingly.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Masking is not possible.

Study Groups

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Intervention arm in the ADHOC Trial (about 300 patients randomised to the intervention arm)

A general practice-based healthcare professional will carry out the consultation and randomise participants to either the intervention or control group. Healthcare professionals will open a separate REDCap database to obtain the (automatically-generated) group assignment for the patient - either intervention or control - and will deliver the rest of the consultation accordingly. The intervention will consist of a one-off, face-to-face consultation with a practice-based clinician, followed by engagement with the Asthma + Lung UK online health community. The intervention will be delivered at the general practice with which each participant is registered.

Group Type EXPERIMENTAL

A digital social intervention by primary care clinicians

Intervention Type BEHAVIORAL

* Signposting to the online health community by explaining different sections of the website.
* Introducing norms and values for passive (just reading) and active (writing posts) participation.
* Motivation for engagement with the online health community, emphasising that it could be used ad hoc (e.g. when feeling unwell, or when they need information or emotional support).
* Problem solving with respect to any difficulties/concerns.
* Signing patients up to the online health community, by explaining terms and conditions.
* Explaining the differences between posting publicly and privately (public posts are shared with third parties whereas private messages to other users are not shared).
* Collection of baseline measures. Data will be entered into the study's online database.

Patients will leave the consultation with a leaflet summarising all procedural matters in relation to signing up with the online health community and a reminder of their username and password.

Control arm (about 300 patients randomised to the control arm)

Control group patients will receive usual care alone, without any reference to online health communities and online peer support.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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A digital social intervention by primary care clinicians

* Signposting to the online health community by explaining different sections of the website.
* Introducing norms and values for passive (just reading) and active (writing posts) participation.
* Motivation for engagement with the online health community, emphasising that it could be used ad hoc (e.g. when feeling unwell, or when they need information or emotional support).
* Problem solving with respect to any difficulties/concerns.
* Signing patients up to the online health community, by explaining terms and conditions.
* Explaining the differences between posting publicly and privately (public posts are shared with third parties whereas private messages to other users are not shared).
* Collection of baseline measures. Data will be entered into the study's online database.

Patients will leave the consultation with a leaflet summarising all procedural matters in relation to signing up with the online health community and a reminder of their username and password.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

To participate in the study, participants will need to:

* Be adult asthma patients (aged 18 to 99) who have expressed their interest in digital social interventions in the recruitment survey.
* Report troublesome asthma (i.e. an ACT score of less than 20) in the recruitment survey).
* Be competent to consent for themselves, as determined by the healthcare professional delivering the consultation.

There are no specific criteria for selecting participants for the exit interviews (a convenience sample of patients and clinicians will be used and recruitment will continue until data saturation).

Exclusion Criteria

* Patients who are already members of the Asthma + Lung UK online health community or other asthma online health communities/Facebook groups (i.e. general use of social media will not prevent participation).
* Palliative or end of life patients.
* Patients receiving institutional long-term care (receiving total care in residential homes or living in nursing homes).
* Patients considered unsuitable to take part in the study by their general practitioners/nurses.

There are no specific criteria for selecting participants for the exit interviews (a convenience sample of patients and clinicians will be used and recruitment will continue until data saturation).
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute for Health Research, United Kingdom

OTHER_GOV

Sponsor Role collaborator

City, University of London

OTHER

Sponsor Role collaborator

University of Cambridge

OTHER

Sponsor Role collaborator

University of Edinburgh

OTHER

Sponsor Role collaborator

University of Nottingham

OTHER

Sponsor Role collaborator

University of Surrey

OTHER

Sponsor Role collaborator

St George's, University of London

OTHER

Sponsor Role collaborator

Asthma UK

OTHER

Sponsor Role collaborator

Queen Mary University of London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anna De Simoni, PhD

Role: PRINCIPAL_INVESTIGATOR

Clinical Reader in Primary Care Research, Queen Mary University of London

Locations

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South West Peninsula Regional Research Delivery Network

Exeter, , United Kingdom

Site Status NOT_YET_RECRUITING

East Midlands Regional Research Delivery Network

Leicester, , United Kingdom

Site Status RECRUITING

North London Regional Research Delivery Network

London, , United Kingdom

Site Status RECRUITING

North East and North Cumbria

Newcastle upon Tyne, , United Kingdom

Site Status RECRUITING

East of England Regional Research Delivery Network

Norwich, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Anna De Simoni, PhD

Role: CONTACT

+442078822520

Georgios Karampatakis, PhD

Role: CONTACT

References

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Karampatakis GD, Wood HE, Griffiths CJ, Taylor SJC, Toffolutti V, Bird VJ, Lea NC, Ashcroft RE, Day B, Coulson NS, Panzarasa P, Li X, Sheikh A, Relton C, Sastry N, Watson JS, Marsh V, Mant J, Mihaylova B, Walker N, De Simoni A. Non-randomised feasibility study testing a primary care intervention to promote engagement in an online health community for adults with troublesome asthma: protocol. BMJ Open. 2023 Jul 11;13(7):e073503. doi: 10.1136/bmjopen-2023-073503.

Reference Type BACKGROUND
PMID: 37433727 (View on PubMed)

Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res. 2023 Sep 27;25:e44886. doi: 10.2196/44886.

Reference Type BACKGROUND
PMID: 37756051 (View on PubMed)

Karampatakis GD, Kimber S, Wood HE, Griffiths CJ, Taylor SJC, Li X, Day B, Mant J, Relton C, Watson JS, Marsh V, Coulson NS, De Simoni A. Development of the face-to-face component and recruitment strategy of a primary care digital social intervention for patients with asthma: Qualitative focus groups and interviews with stakeholders. Eur J Gen Pract. 2024 Dec;30(1):2407594. doi: 10.1080/13814788.2024.2407594. Epub 2024 Sep 27.

Reference Type BACKGROUND
PMID: 39329323 (View on PubMed)

Karampatakis GD, Wood HE, Griffiths CJ, Taylor SJ, Toffolutti V, Bird VJ, Lea NC, Ashcroft R, Coulson NS, Panzarasa P, Li X, Sheikh A, Relton C, Sastry N, Watson JS, Mant J, Marsh V, Day B, Mihaylova B, Walker N, De Simoni A. Randomised controlled trial to measure effectiveness and cost-effectiveness of a digital social intervention promoted by primary care clinicians to adults with asthma to improve asthma control: protocol. BMJ Open. 2025 Sep 11;15(9):e104367. doi: 10.1136/bmjopen-2025-104367.

Reference Type BACKGROUND
PMID: 40940055 (View on PubMed)

Other Identifiers

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349517

Identifier Type: -

Identifier Source: org_study_id

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