RecruitingNot ApplicableNCT05844891

Telehealth-Enhanced Asthma Care for Home After the Emergency Room

Telehealth-Enhanced Asthma Care for Home After the Emergency Room (TEACH-ER)

Sponsor

University of Rochester

Enrollment

430 participants

Start Date

Apr 1, 2024

Study Type

INTERVENTIONAL

Conditions

Asthma in Children

Summary

The investigators propose a randomized controlled trial of Telehealth-Enhanced Asthma Care for Home After the Emergency Room (TEACH-ER) vs. enhanced care (EC). TEACH-ER includes: 1) brief, pictorial, and health literacy-informed asthma education in the ED, with color- and shape-coded labels provided for home asthma medications; 2) virtual primary care follow-up within 1 week of discharge using in-home telemedicine (Zoom) when possible, featuring provider prompts for guideline-based preventive therapy and home delivery of prescribed medications with pictorial action plans; 3) two additional in-home virtual visits to reinforce teaching, review treatment plans, label medications, and support effective management practices. The investigators will enroll 430 children (ages 3-12 yrs) from the two dedicated pediatric EDs in our region, and follow all participants for a 12-month period. The investigators will call caregivers to complete blinded follow-up telephone surveys at 3, 6, 9, and 12 months after discharge. The investigators will assess the effectiveness of TEACH-ER in reducing the need for additional asthma-related ED visits or hospitalizations in the 1-months after enrollment. Additional outcomes of interest include asthma symptoms, medication adherence, absenteeism from work and school, quality of life, and the delivery of care consistent with national asthma care guidelines.

Eligibility

Min Age: 3 YearsMax Age: 12 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether giving families video-based follow-up care (telehealth) after a child's emergency room visit for asthma can reduce future asthma attacks and ER trips. The idea is that better ongoing support at home can keep children's asthma under control. **You may be eligible if...** - Your child has a doctor-confirmed asthma diagnosis - Your child is currently being treated in the ER for an asthma flare-up - Your child has persistent or poorly controlled asthma - You have access to a device that can do video calls - Your child is between 2 and 17 years old **You may NOT be eligible if...** - Your child has other serious lung conditions (like cystic fibrosis) or immune deficiencies - Your child does not speak English or Spanish - Your family does not have internet access or a video-capable device - Your child is being admitted to intensive care Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALTelehealth-Enhanced Asthma Care for Home After the Emergency Room (TEACH-ER)

TEACH-ER aims to provide primary care management and educational support for families managing childhood asthma throughout the transition from emergency department to home, and includes several core components: 1) brief, pictorial, and health literacy-informed asthma education in the ED, with color- and shape-coded labels provided for home asthma medications; 2) virtual primary care follow-up within 1 week of discharge using in-home telemedicine (when possible), featuring provider prompts for guideline-based preventive therapy and home delivery of prescribed medications with pictorial action plans; 3) two additional in-home virtual visits to reinforce teaching, review treatment plans, label medications, and support effective management practices. Virtual visits will be completed using the Zoom platform on smartphones or other compatible devices. We anticipate that all three telehealth visits (1 provider visit, 2 educator visits) will be completed within 2 months of enrollment.

BEHAVIORALEnhanced Care (EC)

Similar to children in the TEACH-ER group, participants in the EC group will receive a symptom assessment using NHLBI guidelines, a recommendation for appropriate preventive medications, and asthma education materials given at the time of the ED visit. After baseline and randomization, we will send the child's PCP a symptom report with guideline-based recommendations for preventive care and recommend a follow-up visit with the PCP. We will also give all providers a summary of the current national guidelines. We will provide systematic feedback to the family and child's PCP at intervals that parallel the TEACH-ER group's telemedicine assessments. This feedback will include prompting caregivers to schedule a recommended follow-up appointment with the PCP, and encouraging providers to adhere to the NHLBI guidelines. While participants will not be blinded to their group allocation, they will be told that they are randomly assigned to two different ways of approaching asthma management.