A Three-part Intervention to Improve Regular Care for Asthma After a Pediatric Emergency Department Visit: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 439
- 试验地点
- 2
- 主要终点
- Follow-up with a Primary Care Physician (PCP)
研究概览
简要总结
The study will assess the efficacy of a three-part Emergency Department (ED)-based "Asthma Belief and Control" intervention on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an Emergency Department visit.
详细描述
Inner-city children are particularly at risk for poor asthma treatment outcomes and frequently obtain their asthma care in the ED. Prior studies have had limited success in improving primary care follow-up, quality of care, and long-term outcomes after a pediatric ED visit for asthma. Prior ED-based interventions have been designed to address barriers to follow-up with a primary care provider (PCP) such as an inability to obtain a follow-up appointment or lack of transportation. Focus groups and surveys of inner-city families have found that beliefs about the benefits of follow-up care and the role of preventive asthma medications have a strong impact on adherence to therapy.
This study will develop a brief educational video about the benefits of follow-up asthma care using a multi-disciplinary panel of experts at the Children's Hospital of Philadelphia and focus groups of parents of children with asthma. This educational video will then be combined into an intervention along with symptom screening and a reminder phone call that has been demonstrated to improve follow-up rates in a previous study. The combined intervention will be tested using a randomized trial design to determine its efficacy on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an ED visit. The research is conducted as part of a research career development award.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 1 Year 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 1-18 years
- •History of Asthma:
- •At least 2 prior episodes of bronchodilator treatment
- •No underlying cardiac disease
- •No other chronic lung disease
- •Residence within Philadelphia city limits
- •Discharged from ED after treatment for asthma
排除标准
- •Prior study enrollment
- •Parent unable to speak English
- •No telephone to be reachable for follow-up calls
结局指标
主要结局
Follow-up with a Primary Care Physician (PCP)
时间窗: 4 weeks, 3 months and 6 months after Emergency Department visit
At baseline, all subjects will complete the Parental Impressions of the Benefits (pros) and barriers (cons) of Follow-Up Care Scale (24-item instrument designed to measure perceived benefits and barriers to follow-up after an ED visit). Follow-up telephone contact will be made by the Primary Investigator or a research assistant after the initial Emergency Department visit. The person making the call will be unaware of the subjects group assignment (control or intervention). Families will be asked about the number of asthma-related follow-up visits which have been made to the Primary Care Physician. Information provided by families will be verified by medical record review.
次要结局
- Return to the Emergency Department for an asthma-related visit.(4 weeks, 3 months and 6 months after Emergency Department visit.)
- Persistent asthma symptoms(4 weeks, 3 months and 6 months after Emergency Department visit)
- Asthma Controller prescriptions by Primary Care Physician (PCP)(4 weeks, 3 months and 6 months after Emergency Department visit)
- Asthma controller medication use(4 weeks, 3 months and 6 months after Emergency Department visit)
- Days of school/work missed(4 weeks, 3 months and 6 months after Emergency Department visit)
- Quality of life(4 weeks, 3 months and 6 months after Emergency Department visit)
- Peak expiratory flow(4 weeks, 3 months and 6 months after Emergency Department visit)