Evidence map›Paper›PMID 27931242›Full record

Trial reportTrials2016

Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma.

Gaylor Hoskins, Brian Williams, Purva Abhyankar, Peter Donnan, Edward Duncan, Hilary Pinnock, Marjon van der Pol, Petra Rauchhaus, Anne Taylor, Aziz Sheikh

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 5 pooled it
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 5 syntheses or guidelines pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. The experience of shared decision-making for people with asthma: A systematic review and metasynthesis of qualitative studies.Health expectations : an international journal of public participation in health care and health policy · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Gaylor HoskinsNursing, Midwifery and Allied Health Professions Research Unit, School of Health Sciences, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. gaylor.hoskins@stir.ac.uk.ORCID 0000-0002-8393-2342
Brian WilliamsSchool of Nursing, Midwifery and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, Scotland.
Purva AbhyankarFaculty of Health Sciences and Sport, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
Peter DonnanTayside Clinical Trials Unit, Level 10 Ninewells Hospital and Medical School, Dundee, DD1 9SY, Scotland, UK.
Edward DuncanNursing, Midwifery and Allied Health Professions Research Unit, School of Health Sciences, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
Hilary PinnockAsthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK.
Marjon van der PolHealth Economics Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK.
Petra RauchhausTayside Clinical Trials Unit, Level 10 Ninewells Hospital and Medical School, Dundee, DD1 9SY, Scotland, UK.
Anne TaylorFaculty of Health Sciences and Sport, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
Aziz SheikhAsthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK.
University of Stirling · GBAsthma UK · GBNinewells Hospital · GBEdinburgh Napier University · GBUniversity of Aberdeen · GB

Funding

Chief Scientist Office CZH/4/697Chief Scientist Office HERU1Chief Scientist Office NMAHP1Chief Scientist Office NMAHP2
6 · The paper itself

Abstract

backgroundDespite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review.

methodsThe 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. The primary outcome was asthma-specific quality of life. Semi-structured interviews with a purposive patient sample (n = 14) and 10 participating nurses explored GOAL perception. The constructs of normalisation process theory (NPT) were used to analyse and interpret data.

resultsTen practices participated (five in each arm), exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At 6 months post-intervention, the difference in mean asthma-related quality of life (mAQLQ) between intervention and control was 0.1 (GOAL 6.20: SD 0.76 (CI 5.76-6.65) versus UC 6.1: SD 0.81 (CI 5.63-6.57)), less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at 6 months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17. Routine review with goal setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses, who admitted to screening out patient goals they believed were unrelated to asthma.

conclusionsThe difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the intervention may have impact if appropriately strengthened. The GOAL intervention changed the review dynamic and was well received by patients, but necessitated additional time, which was problematic in the confines of the traditional nurse appointment. Modification to recruitment methods and further development of the intervention are needed before proceeding to a definitive cluster randomised controlled trial.

trial registrationISRCTN18912042 . Registered on 26 June 2012.

Indexed as

CommunicationPatient Care PlanningPhysician-Nurse RelationsPrimary Care NursingPrimary Health CareQuality of LifeSelf CareAdultAgedAged, 80 and overAsthmaAttitude of Health PersonnelCost of IllnessFeasibility StudiesFemaleHealth Knowledge, Attitudes, PracticeAsthmaComplex interventionsGoal settingMixed methodsPilot cluster RCTSelf-management

Identifiers

PMID27931242
PMCPMC5146838
OpenAlexW2560270698

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.