Use of Text Messages to Improve Care For Children Following an ED Visit for Asthma

Not Applicable

• Conditions: Asthma
• Interventions: Behavioral: Targeted text messages; Behavioral: General text messages

• Registration Number: NCT02436070
• Lead Sponsor: Children's Hospitals and Clinics of Minnesota

Brief Summary

BACKGROUND Asthma is a prevalent and troublesome pediatric condition. In 2013, Emergency Department (ED) providers treated over 3,500 cases of asthma-related complaints at Children's Hospitals and Clinics of Minnesota. Pediatric ED visits for asthma exceeds billions of dollars annually when including direct cost and lost productivity. Many of these visits and resultant costs are avoidable. Patients with well-controlled asthma do not typically exhibit these patterns, while patients with poorly controlled asthma show patterns of increased utilization of healthcare resources and lower quality of life. Evidence suggests that a text message reminder and educational program might positively influence pediatric asthma care practices.

RESEARCH QUESTION Does a targeted ED based text message intervention program improve outpatient follow-up and routine preventive care in pediatric asthma patients?

METHODS Study subjects will be block randomized based on age and insurance group. The experimental group will receive text messages with guidance towards follow-up care with their PCP and the importance of the flu vaccine for children with asthma. The control group will receive a series of educational self-care and health based text messages unrelated to asthma or the flu vaccine. Some self-report of behaviors will be captured via text message response.

ANALYSIS Primary outcomes for the educational versus targeted text message groups will be compared use Chi-square tests. Additional adjustments may be applied for missing data or if, despite randomization, there is substantial imbalance between group in key covariates (eg race/ethnicity, insurance type or asthma severity.)

Detailed Description

Not available

Study Timeline

• Study Start: 2014-10
• Study First Submitted: 2015-05-01
• Study First Submitted QC: 2015-05-01
• Study First Posted: 2015-05-06
• Status Verified: 2017-11
• Last Update Submitted: 2017-11-20
• Last Update Posted: 2017-11-22
• Primary Completion: 2018-12
• Study Completion: 2018-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 195

Inclusion Criteria

• Caregivers of patients aged 4 - 17 years (inclusive) will be eligible for study participation if they meet the following criteria:

  1. Presentation to the ED with a chief complaint related to an asthma exacerbation such as shortness of breath, respiratory distress, wheezing, etc...
  2. Receive an albuterol treatment in the ED
  3. Previous history of asthma as represented in the medical record or by parental report
  4. Have a cell phone that is able to receive text messages
  5. Able to communicate and provide consent in English or Spanish

Exclusion Criteria

• Caregivers of patients will be excluded from this study for the following reasons:

  1. First episode of wheezing

  2. Admitted to the hospital

  3. Co-morbid respiratory disease:

     1. Cystic fibrosis
     2. Bronchiectasis
     3. Pulmonary hypertension
     4. Other chronic lung disease

  4. Current cancer diagnosis

  5. Previous cardiovascular surgery

  6. Inflammatory bowel disease

  7. Sickle Cell disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Test group	Targeted text messages	Subjects receive specific, targeted text messages for post-emergency department discharge asthma care.
Control	General text messages	Subjects receive general, health-related text messages applicable for children with asthma.

Primary Outcome Measures

Name	Time	Method
Follow-up care with primary care provider	1 week after emergency department discharge	Assessed via text and follow-up call if no response to text message

Secondary Outcome Measures

Name	Time	Method
Influenza vaccine	30 days after emergency department discharge	Assessed via text and follow-up call if no response to text message
Return visit to the emergency department	30 days after the inaugural emergency department visit	Assessed via text and follow-up call if no response to text message; Our health record also checked for return visits

Trial Locations

Locations (2)

Children's Hospitals and Clinics of Minnesota - Emergency Department; 🇺🇸 Minneapolis, Minnesota, United States

Children's Minnesota; 🇺🇸 Saint Paul, Minnesota, United States