Effectiveness of Telemedicine Home Assessments for Identification and Reduction of Asthma Triggers

Study Overview
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Brief Summary
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The study is about comparing asthma home assessments/interventions by telemedicine compared to providing education alone. Interactive Video (IAV) defines telemedicine. It allows two-way communication in real-time with both audio and visual communication between the subject and someone from the study team. It is similar to using Face Time on a mobile device. Asthma home assessments/interventions are used to identify things in a home that can make asthma symptoms worse, called triggers. Reducing these triggers in the home can improve asthma.

Detailed Description
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In this study, supplies will be given to some participants to help reduce or remove triggers from the home. One example is dust mites. These are microscopic bugs that are found in every home, cannot be seen by the naked eye, and make asthma symptoms worse. Part of the study includes collecting two dust samples from home to check dust mite levels at the beginning of the study and at the end. This study may help elucidate whether telemedicine home assessments work better than education alone at lowering dust mite levels and improving a child's asthma symptoms.

Official Title
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Effectiveness of Telemedicine Home Assessments for Identification and Reduction of Asthma Triggers

Conditions
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Asthma in Children

Intervention / Treatment
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* Behavioral: Standard of Care Education
* Other: Interactive Video (IAV) Telemedicine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 5 years and ≤ 18 years Have a diagnosis of persistent asthma as defined by national guidelines criteria1 Patient receives care in Arkansas Children's Hospital (ACH) primary care, in patient and/or specialty clinics Patient has had at least one or more acute exacerbations of asthma within the 12 months prior to enrollment that led to an emergency department visit, hospital admission, or prescription for systemic steroids English speaking participants/parents Access to WIFI, smartphone or mobile device (tablet) Exclusion Criteria: Age <5 or >18 years Non-English speaking participants/parents Patients not receiving primary and/or asthma specialty care or inpatient services at ACH Inability of patient or family to participate in TM evaluation due to lack of access to WIFI or smartphone or mobile device

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Telemedicine Arm<br>For the proposed study, participants will randomized to receive TM home assessments/interventions performed by a trained home visitor (HV) or standard of care asthma trigger education by the HV. Those who are randomized to TM home assessments/interventions will complete a baseline home assessment and two follow-up visits, 2 months apart. Visits will assess the presence of potential asthma triggers in the home and frequency of asthma symptoms/exacerbations. TM participants will be provided education and materials necessary to reduce asthma triggers in the home. Follow-up visits will assess the interval change in presence of asthma triggers, change in daily asthma symptoms/exacerbations, and participant/family retention of education. | Other: Interactive Video (IAV) Telemedicine<br>* Interactive video assessment of asthma triggers in the home.<br>|
| Active Comparator: Standard of Care Education<br>For subjects randomized to receive standard of care asthma education, written and verbal information will be provided regarding identification and removal of potential asthma triggers in the home but no formal assessment of the home will be performed, nor will participants in this arm receive trigger reduction materials. | Behavioral: Standard of Care Education<br>* Education regarding recognition and removal of in-home asthma triggers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in asthma-related triggers | Changes in dust mite levels in home collected dust | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Asthma Control Test (ACT) | from baseline to 6 months | 6 months | 
| Changes in healthcare utilization | measured as either an increase or decrease in visits to a healthcare provider and/or medication pick-up from baseline to end of study | 6 months | 
| Patient Satisfaction | as assessed via survey | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Asthma, Telemedicine