Clinical trial NCT00113633: Educational Video for Improving Follow-up After an Emergency Department Visit for Asthma
Official title: A Three-part Intervention to Improve Regular Care for Asthma After a Pediatric Emergency Department Visit: A Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Asthma
Keywords: Asthma
Emergency
Primary Care
Children
Lead sponsor: Children's Hospital of Philadelphia
Sponsor class: OTHER
Collaborators: name: National Heart, Lung, and Blood Institute (NHLBI)
First posted: 2005-06-10
Enrollment: 439
Sex: ALL
Minimum age (years): 1
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The study will assess the efficacy of a three-part Emergency Department (ED)-based "Asthma Belief and Control" intervention on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an Emergency Department visit.

Detailed description: Inner-city children are particularly at risk for poor asthma treatment outcomes and frequently obtain their asthma care in the ED. Prior studies have had limited success in improving primary care follow-up, quality of care, and long-term outcomes after a pediatric ED visit for asthma. Prior ED-based interventions have been designed to address barriers to follow-up with a primary care provider (PCP) such as an inability to obtain a follow-up appointment or lack of transportation. Focus groups and surveys of inner-city families have found that beliefs about the benefits of follow-up care and the role of preventive asthma medications have a strong impact on adherence to therapy.

This study will develop a brief educational video about the benefits of follow-up asthma care using a multi-disciplinary panel of experts at the Children's Hospital of Philadelphia and focus groups of parents of children with asthma. This educational video will then be combined into an intervention along with symptom screening and a reminder phone call that has been demonstrated to improve follow-up rates in a previous study. The combined intervention will be tested using a randomized trial design to determine its efficacy on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an ED visit. The research is conducted as part of a research career development award.

Eligibility criteria: Inclusion Criteria:

* Age 1-18 years
* History of Asthma:
* At least 2 prior episodes of bronchodilator treatment
* No underlying cardiac disease
* No other chronic lung disease
* Residence within Philadelphia city limits
* Discharged from ED after treatment for asthma

Exclusion Criteria:

* Prior study enrollment
* Parent unable to speak English
* No telephone to be reachable for follow-up calls

Primary outcomes:
measure: Follow-up with a Primary Care Physician (PCP)
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
Secondary outcomes:
measure: Return to the Emergency Department for an asthma-related visit.
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit.
measure: Persistent asthma symptoms
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
measure: Asthma Controller prescriptions by Primary Care Physician (PCP)
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
measure: Asthma controller medication use
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
measure: Days of school/work missed
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
measure: Peak expiratory flow
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
measure: Quality of life
timeFrame: 4 weeks, 3 months and 6 months after Emergency Department visit
Other outcomes:
Locations:
city: Philadelphia
country: United States
facility: Children's Hospital of Philadelphia
state: Pennsylvania
Study officials:
affiliation: Children's Hospital of Philadelphia
name: Joseph J. Zorc
role: PRINCIPAL_INVESTIGATOR
References:
citation: Zorc JJ, Chew A, Allen JL, Shaw K. Beliefs and barriers to follow-up after an emergency department asthma visit: a randomized trial. Pediatrics. 2009 Oct;124(4):1135-42. doi: 10.1542/peds.2008-3352. Epub 2009 Sep 28.