Repeat Emergency Department Visits Among Patients With Asthma and COPD
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 6
- 试验地点
- 1
- 主要终点
- Percentage of Subjects With a Return Visit to the ED Within 30 Days of ED Discharge
研究概览
简要总结
The purpose of the proposed study is to determine whether the addition of inhaled corticosteroids to treatment with oral corticosteroids and albuterol would reduce repeat emergency department (ED) visits among patients treated for acute exacerbations of asthma and COPD discharged from the emergency department to home. The investigators hypothesize that patients treated with inhaled corticosteroids in addition to oral corticosteroids and albuterol will have lower rates of 30-day return visits to the emergency department than those patients treated with oral corticosteroids and albuterol only.
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
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Treated in the ED at the Erie County Medical Center (ECMC) for acute symptoms of asthma or COPD during the study period
- •Patient age ≥ 18 years
- •Resident of the City of Buffalo or Erie County
- •Discharged to home
- •Patient expresses willingness to return to ECMC or own primary care provider for follow-up visits
- •Able to provide informed consent
- •Able to comprehend English language
排除标准
- •Received oral or inhaled corticosteroids in the week before ED presentation
- •Presented to the ED primarily for prescription refills
- •Complicated comorbid conditions (e.g. renal disease, cardiovascular disease, CHF, HIV)
- •Admitted to ECMC or discharged to another facility
- •Previously enrolled during a prior visit to the ED during the study period
- •For female patients--pregnant or pregnancy status indeterminate
- •Antibiotics are prescribed to treat current asthma/COPD exacerbation.
研究组 & 干预措施
Standard of Care
Standard of Care: 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 4 days (1st dose will have been given in the ED)
Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.
干预措施: albuterol (Drug)
Standard of Care
Standard of Care: 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 4 days (1st dose will have been given in the ED)
Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.
干预措施: Prednisone (Drug)
Treatment
Treatment: 30 day QVAR® (beclamethasone dipropionate) inhaler (80 mcg, 1 puff twice daily) plus 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 5 days
Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.
干预措施: beclamethasone dipropionate (Drug)
Treatment
Treatment: 30 day QVAR® (beclamethasone dipropionate) inhaler (80 mcg, 1 puff twice daily) plus 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 5 days
Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.
干预措施: albuterol (Drug)
Treatment
Treatment: 30 day QVAR® (beclamethasone dipropionate) inhaler (80 mcg, 1 puff twice daily) plus 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 5 days
Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.
干预措施: Prednisone (Drug)
结局指标
主要结局
Percentage of Subjects With a Return Visit to the ED Within 30 Days of ED Discharge
时间窗: 30 days
Subjects' medical records will be reviewed for the 30 day period following ED discharge to determine if they return to the treating ED or another regional ED for treatment of an acute asthma/COPD exacerbation. Regional ED records will be queried by use of data maintained by HEALTHeLINK, our regional health information organization system. This will allow for more complete capture of ED return visits that could be obtained by looking only at a single ED.
次要结局
未报告次要终点
研究者
Heather Lindstrom
Research Assistant Professor
State University of New York at Buffalo