Asthma Patient Education in the Emergency Room

Study Overview
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Brief Summary
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The objective of this randomized trial is to assess the effectiveness of an intervention involving education, self-efficacy, and social support in improving quality of life outcomes among 296 adult asthma patients treated in the emergency room. The main outcome will be a comparison of within-patient change in quality of life between enrollment and 8 weeks. Secondary objectives will be to assess the effectiveness of the intervention in decreasing the need for rescue inhaled beta agonists, in improving peak flow meter rates, and in decreasing the number of days lost from work or school due to asthma. These outcomes will be measured again at 16 weeks to determine if benefits are sustained. Additional outcomes at 16 weeks and 1 year will be to assess the effectiveness of the intervention in decreasing urgent resource utilization for asthma and cost effectiveness.

Detailed Description
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BACKGROUND: Many urban asthma emergency room patients lack effective self-management. Most current training programs are administered in outpatient settings and have low attendance rates for emergency room patients. There is a great need to develop effective programs that can be easily administered in the emergency room for patients who, in many cases, are not present in other settings to receive education. This proposal builds on preliminary studies and is tailored to provide emergency room patients with basic education during a teachable moment when they may be most receptive to asthma information. DESIGN NARRATIVE: Patients will be recruited from two New York City urban emergency rooms or inpatient settings and randomized to the intervention or control groups. Intervention patients will receive a protocol focusing on asthma self-management, education, self-efficacy, and social support, with telephone reinforcement for 8 weeks. Control patients will receive standard emergency room education about asthma.

Official Title
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Trial of Asthma Patient Education in the Emergency Room

Conditions
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Asthma

Intervention / Treatment
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* Behavioral: Asthma Education in Adults
* Behavioral: Standard Emergency Room Asthma Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients will be eligible if they are 18 years of age or older Fluent in English Have a known diagnosis of asthma Will receive treatment for asthma during the current hospitalization or emergency room visit. Exclusion Criteria: Cognitive deficits Other pulmonary diseases or severe comorbidity Do not have out-patient access to a telephone

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 95 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Intervention participants will receive information focusing on asthma self-management, education, self-efficacy, and social support while in the hospital emergency room. Telephone reinforcement will occur for 8 weeks following study entry. | Behavioral: Asthma Education in Adults<br>* The intervention involves enhancing asthma education, asthma self-efficacy and asthma-related social support and is administered during a single in-person session in the ED (or hospital for admitted patients) followed by telephone reinforcement.<br>|
| Active Comparator: 2<br>Participants in the control group will receive standard emergency room education about asthma. | Behavioral: Standard Emergency Room Asthma Education<br>* Participants will receive standard emergency room education about asthma.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life |  | Measured at 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rescue inhaled beta agonist use |  | Measured at 8 weeks | 
| Peak flow meter rates |  | Measured at 8 weeks | 
| Number of days lost from work or school due to asthma |  | Measured at 8 weeks | 
| Decreasing urgent resource utilization for asthma |  | Measured at 16 weeks and 1 year | 
| Cost effectiveness |  | Measured at 16 weeks and 1 year |