Educational Video for Improving Follow-up After an Emergency Department Visit for Asthma

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Asthma

Treatments: Behavioral: Intervention Subjects

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00113633

2004-12-4130

K23HL074250 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 439 patients

Sex: All

Ages: 1 to 18 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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439 participants in 2 patient groups

Control Subjects

No Intervention group

Description:

These subjects will receive standard discharge instructions that recommend follow-up with a PCP within 3-5 days.

Intervention Subjects

Experimental group

Description:

As part of the intervention, the family will view a brief educational video about asthma control and therapy developed using provider and patient focus groups. For children reporting persistent asthma symptoms, a letter will be given to the family to bring to their PCP stating that screening revealed symptoms that may require further treatment with controller medications. A mailed reminder to schedule a follow-up appointment will be sent to the family.

Treatment:

Behavioral: Intervention Subjects