Telehealth-Enhanced Asthma Care for Home After the Emergency Room (TEACH-ER)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Asthma in Children
- Sponsor
- University of Rochester
- Enrollment
- 430
- Locations
- 1
- Primary Endpoint
- Number of asthma-related hospitalizations and emergency department visits after discharge
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The investigators propose a randomized controlled trial of Telehealth-Enhanced Asthma Care for Home After the Emergency Room (TEACH-ER) vs. enhanced care (EC). TEACH-ER includes: 1) brief, pictorial, and health literacy-informed asthma education in the ED, with color- and shape-coded labels provided for home asthma medications; 2) virtual primary care follow-up within 1 week of discharge using in-home telemedicine (Zoom) when possible, featuring provider prompts for guideline-based preventive therapy and home delivery of prescribed medications with pictorial action plans; 3) two additional in-home virtual visits to reinforce teaching, review treatment plans, label medications, and support effective management practices. The investigators will enroll 430 children (ages 3-12 yrs) from the two dedicated pediatric EDs in our region, and follow all participants for a 12-month period. The investigators will call caregivers to complete blinded follow-up telephone surveys at 3, 6, 9, and 12 months after discharge. The investigators will assess the effectiveness of TEACH-ER in reducing the need for additional asthma-related ED visits or hospitalizations in the 1-months after enrollment. Additional outcomes of interest include asthma symptoms, medication adherence, absenteeism from work and school, quality of life, and the delivery of care consistent with national asthma care guidelines.
Investigators
Sean Frey
Associate Professor
University of Rochester
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- •An inability to speak and understand English. Parents (and children) with low literacy / health-literacy skills will be eligible, as survey instruments will be administered verbally and educational materials will be designed for low-literacy populations.
- •No access to a working phone for follow-up surveys (either at the subject's home or an easily accessible location). If a subject does not have access to an appropriate device for Zoom visits at home, we will provide a device with required data plan.
- •Other significant medical conditions, including cystic fibrosis, congenital heart disease, or other chronic lung disease, that could interfere with the assessment of asthma-related measures.
- •Children in foster care or other situations in which consent cannot be obtained from a legal guardian.
Outcomes
Primary Outcomes
Number of asthma-related hospitalizations and emergency department visits after discharge
Time Frame: 12 months
Asthma-related hospitalizations or emergency department visits, and drawn from objective healthcare utilization data in the electronic health record
Secondary Outcomes
- Caregiver-reported Asthma control (NHLBI)(Baseline, 3 months, 6 months, 9 months, 12 months)
- Missed school due to asthma in the past 2 weeks(Baseline, 3 months, 6 months, 9 months, 12 months)
- Caregiver quality of life([Time Frame: 2 months, 4 months, 6 months])
- Symptom-Free Days (SFD) in the past 2 weeks(Baseline, 3 months, 6 months, 9 months, 12 months)
- Missed work due to asthma in the past 2 weeks(Baseline, 3 months, 6 months, 9 months, 12 months)
- Caregiver-reported Medication adherence(Baseline, 3 months, 6 months, 9 months, 12 months)