Repeat Emergency Department Visits Among Patients With Asthma and COPD

University at Buffalo (UB)

Status: Terminated

Conditions: Asthma; COPD

Treatments: Drug: Prednisone; Drug: beclamethasone dipropionate; Drug: albuterol

Study type: Interventional

Funder types: Other

Identifiers

NCT02499887

754754

Details and patient eligibility

About

The purpose of the proposed study is to determine whether the addition of inhaled corticosteroids to treatment with oral corticosteroids and albuterol would reduce repeat emergency department (ED) visits among patients treated for acute exacerbations of asthma and COPD discharged from the emergency department to home. The investigators hypothesize that patients treated with inhaled corticosteroids in addition to oral corticosteroids and albuterol will have lower rates of 30-day return visits to the emergency department than those patients treated with oral corticosteroids and albuterol only.

Enrollment: 6 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Treated in the ED at the Erie County Medical Center (ECMC) for acute symptoms of asthma or COPD during the study period
• Patient age ≥ 18 years
• Resident of the City of Buffalo or Erie County
• Discharged to home
• Patient expresses willingness to return to ECMC or own primary care provider for follow-up visits
• Able to provide informed consent
• Able to comprehend English language

Exclusion criteria

• Received oral or inhaled corticosteroids in the week before ED presentation
• Presented to the ED primarily for prescription refills
• Complicated comorbid conditions (e.g. renal disease, cardiovascular disease, CHF, HIV)
• Admitted to ECMC or discharged to another facility
• Previously enrolled during a prior visit to the ED during the study period
• For female patients--pregnant or pregnancy status indeterminate
• Antibiotics are prescribed to treat current asthma/COPD exacerbation.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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6 participants in 2 patient groups

Standard of Care

Active Comparator group

Description:

Standard of Care: 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 4 days (1st dose will have been given in the ED) Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.

Treatment:

Drug: albuterol

Drug: Prednisone

Treatment

Experimental group

Description:

Treatment: 30 day QVAR® (beclamethasone dipropionate) inhaler (80 mcg, 1 puff twice daily) plus 30 day albuterol inhaler plus non-tapering course of oral prednisone (50 mg/d) for 5 days Spacers will be dispensed with all multiple dose inhalers (MDI) to promote proper use and administration of inhaled medications.

Treatment:

Drug: albuterol

Drug: Prednisone

Drug: beclamethasone dipropionate