NCT00860418

Brief Summary

Young inner-city children with asthma have the highest emergency department (ED) visit rates. Relying on the emergency department for asthma care can be a dangerous sign of poorly controlled asthma. This research will focus on whether having a specialized asthma nurse join the family at a child's doctor visit after an ED visit for asthma to make sure the child and parent keep the follow-up appointment and have the nurse remind the child's doctor to prescribe preventive asthma medicines and an asthma action plan for home (PAAL intervention) will result in young children with asthma having fewer days with wheezing and cough. The investigators hypothesize that:

  1. 1.Significantly more children receiving the PAAL intervention will attend greater than 2 non-urgent visits and greater than 6 refills for the child's anti-inflammatory medications over 12 months when compared to children in the control or standard asthma education group.
  2. 2.Children in the PAAL intervention group will experience less morbidity and caregivers will experience increased quality of life compared to children in the control of standard asthma education group.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
350

participants targeted

Target at P75+ for phase_2 asthma

Timeline
Completed

Started Sep 2008

Longer than P75 for phase_2 asthma

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2008

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

March 11, 2009

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 12, 2009

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2013

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2013

Completed
Last Updated

September 2, 2015

Status Verified

June 1, 2011

Enrollment Period

4.8 years

First QC Date

March 11, 2009

Last Update Submit

August 31, 2015

Conditions

Keywords

asthmafeedbackanti-inflammatoryED visits

Outcome Measures

Primary Outcomes (1)

  • Number of primary care appointments kept over 12 months

    12 months

Secondary Outcomes (1)

  • Number of refills for anti-inflammatory medications prescribed over 12 months

    12 months

Study Arms (2)

1

ACTIVE COMPARATOR

Standard asthma education delivered during 2 home visits by a nurse.

Behavioral: Standard asthma education

2 PAAL

EXPERIMENTAL

PAAL

Behavioral: Pediatric Asthma Alert (PAAL)

Interventions

Asthma nurse conducts 2 home visits and accompanies the child to primary care provider visit after ED visits

Also known as: Pediatric Asthma Alert Leader (Nurse)
2 PAAL

Standard asthma education during 2 home visits.

Also known as: Asthma Education
1

Eligibility Criteria

Age3 Years - 10 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • All 6 criteria must be met:
  • Physician-diagnosed asthma (based on caregiver report with validation from the child's physician)
  • \> 2 ED visits or \> 1 hospitalization for asthma within past 12 months
  • Mild persistent to severe persistent asthma based on NHLBI guidelines criteria (7-9) having any 1 of the following:
  • An average of \> 2 days per week of asthma symptoms
  • \> 2 days per week with rescue medication use (albuterol, xopenex) OR
  • \> 2 days per month of nighttime symptoms
  • Age \> 3 and \< 10 years
  • Reside in Baltimore Metropolitan area
  • Not currently participating in another asthma study or sibling enrolled in PAAL study

You may not qualify if:

  • Inability to speak and understand English
  • No access to a working phone or alternate phone for follow-up surveys
  • Co-morbid respiratory condition including cystic fibrosis, chronic lung disease (BPD), lung cancer, tracheostomy that could interfere with the assessment of asthma-related outcome measures.
  • Children residing in foster care or where consent cannot be obtained from a legal guardian.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Johns Hopkins University

Baltimore, Maryland, 21287, United States

Location

Related Publications (4)

  • Bellin MH, Margolis RH, Whitney L, Osteen P, Thompson A, Butz AM. Violence Exposure, Child Asthma Morbidity, and Maternal Depressive Symptoms: A Longitudinal Analysis of Cumulative Risk. J Health Care Poor Underserved. 2022;33(1):47-66. doi: 10.1353/hpu.2022.0006.

  • Bellin MH, Osteen P, Kub J, Bollinger ME, Tsoukleris M, Chaikind L, Butz AM. Stress and Quality of Life in Urban Caregivers of Children With Poorly Controlled Asthma: A Longitudinal Analysis. J Pediatr Health Care. 2015 Nov-Dec;29(6):536-46. doi: 10.1016/j.pedhc.2015.04.018. Epub 2015 May 30.

  • Butz AM, Halterman J, Bellin M, Kub J, Tsoukleris M, Frick KD, Thompson RE, Land C, Bollinger ME. Improving preventive care in high risk children with asthma: lessons learned. J Asthma. 2014 Jun;51(5):498-507. doi: 10.3109/02770903.2014.892608. Epub 2014 Feb 27.

  • Butz AM, Halterman JS, Bellin M, Kub J, Frick KD, Lewis-Land C, Walker J, Donithan M, Tsoukleris M, Bollinger ME. Factors associated with completion of a behavioral intervention for caregivers of urban children with asthma. J Asthma. 2012 Nov;49(9):977-88. doi: 10.3109/02770903.2012.721435. Epub 2012 Sep 19.

MeSH Terms

Conditions

Asthma

Interventions

Nurses

Condition Hierarchy (Ancestors)

Bronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System Diseases

Intervention Hierarchy (Ancestors)

Health PersonnelHealth Care Facilities Workforce and Services

Study Officials

  • Arlene M Butz, ScD, RN

    Johns Hopkins University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

March 11, 2009

First Posted

March 12, 2009

Study Start

September 1, 2008

Primary Completion

June 1, 2013

Study Completion

June 1, 2013

Last Updated

September 2, 2015

Record last verified: 2011-06

Locations