Improving Asthma Outcomes in an Urban Pediatric Population

NCT00140439 | Completed

• 1 other identifier: RWJ EDDP
• Study Type: interventional
• Target: 488
• Locations: 1 country
• Sites: 1

Brief Summary

Little is known about how ED-based programs can help to reduce pediatric ED visits for asthma. The current study evaluated a novel intervention in which the ED itself became the site of highly individualized, comprehensive follow-up asthma care. It sought to determine if such an intervention could decrease subsequent unscheduled visits for asthma while improving asthma quality of life.

Conditions

Asthma

Keywords

asthma; emergency department; compliance; randomized clinical trial

Outcome Measures

Primary Outcomes (1)

• Unscheduled visits for asthma

  6 months following enrollment

Secondary Outcomes (4)

• Hospitalizations for asthma

  6 months following enrollment

• Compliance

  6 months following enrollment

• Quality of Life

  6 months following enrollment

• Morbidity

  6 months following enrollment

Interventions

Emergency Department based asthma follow-up clinic BEHAVIORAL

The clinical activities of the intervention followed a fully specified protocol and provided education and care in three domains: 1. Asthma self-monitoring and management: Educators first reviewed the basic physiology of asthma with emphasis on its chronicity. After evaluating asthma severity and treatment history, the physician completed an individualized medical action plan (MAP) and provided any necessary device teaching. 2. Environmental modification and trigger control: After evaluation of potential environmental triggers in the home, each family was educated on their control. Each child was provided hypoallergenic bed encasings. 3. Linkages and referrals to ongoing primary care: Clinic staff stressed the importance of longitudinal asthma care by a PCP. A full report of the clinic visit was mailed to each child's PCP. In addition, the asthma educator scheduled a follow-up appointment with the PCP within 4 weeks

Eligibility Criteria

• Age: 12 Months - 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• age between 12 months and 17 years, inclusive;
• prior physician-diagnosed asthma;
• ≥1 other unscheduled visit for asthma in the previous 6 months and/or ≥1 hospitalization for asthma in the prior 12 months;
• a parent/guardian available for interview;
• residence in Washington, DC or a contiguous Maryland county; and
• requirement for ≥3 doses of nebulized albuterol in the ED at the time of enrollment.

You may not qualify if:

• significant medical co-morbidities affecting the cardiorespiratory system;
• a visit to an allergist or a pulmonologist in the prior 6 months;
• ≥2 of the following: a current written asthma medical action plan, current use of \>1 controller medication, or a scheduled visit for asthma care with their PCP in the prior two weeks;
• enrollment in another asthma research study;
• unavailability for telephone follow-up; or
• primary language other than English or Spanish.

Sponsors & Collaborators

• Stephen J. Teach, MD, MPH: lead
• American Academy of Allergy, Asthma, and Immunology: collaborator
• Robert Wood Johnson Foundation: collaborator

Study Sites (1)

Children's National Medical Center

Washington D.C., District of Columbia, 20010, United States

Location

MeSH Terms

Conditions

Asthma; Emergencies; Patient Compliance

Condition Hierarchy (Ancestors)

Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Stephen J Teach, MD

  Children's National Research Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: August 31, 2005
• First Posted: September 1, 2005
• Study Start: April 1, 2002
• Primary Completion: June 1, 2005
• Study Completion: June 1, 2005
• Last Updated: August 25, 2015

Record last verified: 2015-08

Locations

US (1)