None listed
Conditions
Brief summary
Asthma is the leading cause of Emergency Department presentations and hospital admissions, which are potentially avoidable with appropriate post-hospitalization asthma management. We propose to implement and test a comprehensive model of care, Care from Home Program, that ensures active care coordination between acute and primary care services, establishes linkage with child's school/childcare services and provides home-based follow up services for optimal health outcomes in children with asthma. The aim of this study is to assess the effectiveness of this program on paediatric asthma management for children aged 5-16 years old with any ED visits or hospital admission. The study will be a randomized-controlled trial conducted at the Liverpool Hospital between 2021 and 2023. Both control and intervention groups will receive an asthma resource package upon the child’s hospital discharge, which will include an individualized asthma action plan, standardized asthma information and written instruction to parents/carers with medical follow-up recommendations. In addition, parents/carers of intervention group will receive a 3-monthly reminder text message via their mobile phones, a home visit to assess home environmental triggers and provide asthma education, and assistance to schedule general practitioner (GP) follow-up consultations. Also, the child’s schools will be informed of their asthma-related hospital presentations and provided with access to online asthma training resources for school staff. Outcome measures including health care utilization, asthma control, corticosteroid uses, quality of life, activity limitations, school absence and work absence by parents/carers will be assessed through self-administered questionnaires at baseline, 6 months and 12 months post-enrollment. Differences between control and intervention groups, as well as pre- and post-intervention periods will be evaluated.
Interventions
Interventions of this study will be implemented over a period of 12 months. Each participating child will be provided with the following interventions after discharged from asthma-related hospitalizations:
1. Asthma resource package which will include: (a) copy of "Asthma and Your child: a resource pack for parents and carers" developed by the Aiming for Asthma Improvement in Children (AAIC) team at the Sydney Children's Hospital Randwick. It contains the standardized asthma information aimed at
Interventions of this study will be implemented over a period of 12 months. Each participating child will be provided with the following interventions after discharged from asthma-related hospitalizations: 1. Asthma resource package which will include: (a) copy of "Asthma and Your child: a resource pack for parents and carers" developed by the Aiming for Asthma Improvement in Children (AAIC) team at the Sydney Children's Hospital Randwick. It contains the standardized asthma information aimed at improving parent's/carer's understanding of asthma e.g. symptom recognition, basic physiology of asthma etc; (b) a letter for the general practitioner (GP) informing them of the child's recent hospital visits and clinical best practice and clinical asthma management tips; (c) a letter for school or childcare services informing them of the child's asthma-related hospitalizations and provided access to online options on asthma management training for school/childcare staff; (d) individualized asthma action plan completed by the treating doctor at the hospital; (e) written discharge instructions for parents/carers which will include recommendation for medical follow-up with a GP or paediatrician within 3 days after discharged from the hospital, advice to receive influenza vaccine, information on access to the Asthma Australia Helpline and link to online free asthma education sessions. The Asthma resource package will be given to patients or their parents/carers upon their discharge by the hospital staff. 2. After the participants were discharged from the hospital, the care coordinator of the research team will email discharge instructions and clinical best practice asthma tips to the respective primary care providers/GPs. 3. An automated reminder text message will be sent to the parents/carers every 3 months post-discharge by the care coordinator, advising them of regular medical follow-up of their child with the GP and providing link to free asthma education webinar sessions and access to Asthma Australia Helpline. 4. A virtual home visits of 45-60 minutes will be carried out by the care coordinator using encrypted digital platform such as WhatsApp, FaceTime etc. within 3 months post-hospitalization to assess home environmental triggers and respond to parent/carer concerns relating to the child's asthma management plan. 5. Care coordinator will coordinate with GPs and facilitate a follow-up consultation for the child within 3-5 days after discharge from the hospital. 6. Care coordinator will email the school/childcare services of the participating child to ensure that they are aware of the child's recent asthma hospital presentation and have updated School & Child Services Action Plan for Asthma Flare up and school/childcare staff will have access to online first aid asthma management training. Attendance to online sessions will be self-reporting and collected in the final survey of the study.
Sponsors
University of New South Wales
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
5 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
Key inclusion criteria are: - Children aged between 5-16 years old. - Children with any ED visits or hospital admission for asthma/VIW-related illnesses - Children attended ED or admitted to general paediatric ward at the Liverpool Hospital during the study period.
Exclusion criteria
Exclusion criteria include: • Children with complex conditions e.g., genetic disorders, complex cardiac diseases etc. • Children with significant developmental delays or comorbidities that will significantly limit their ability to participate in the study • Children admitted to intensive care unit (ICU) • Parents/carers who are not fluent in English • Families who do not have permanent housing e.g. lived in a shelter
Outcome results
None listed