Asthma
Conditions
Brief summary
The objective of this randomized trial is to assess the effectiveness of an intervention involving education, self-efficacy, and social support in improving quality of life outcomes among 296 adult asthma patients treated in the emergency room. The main outcome will be a comparison of within-patient change in quality of life between enrollment and 8 weeks. Secondary objectives will be to assess the effectiveness of the intervention in decreasing the need for rescue inhaled beta agonists, in improving peak flow meter rates, and in decreasing the number of days lost from work or school due to asthma. These outcomes will be measured again at 16 weeks to determine if benefits are sustained. Additional outcomes at 16 weeks and 1 year will be to assess the effectiveness of the intervention in decreasing urgent resource utilization for asthma and cost effectiveness.
Detailed description
BACKGROUND: Many urban asthma emergency room patients lack effective self-management. Most current training programs are administered in outpatient settings and have low attendance rates for emergency room patients. There is a great need to develop effective programs that can be easily administered in the emergency room for patients who, in many cases, are not present in other settings to receive education. This proposal builds on preliminary studies and is tailored to provide emergency room patients with basic education during a teachable moment when they may be most receptive to asthma information. DESIGN NARRATIVE: Patients will be recruited from two New York City urban emergency rooms or inpatient settings and randomized to the intervention or control groups. Intervention patients will receive a protocol focusing on asthma self-management, education, self-efficacy, and social support, with telephone reinforcement for 8 weeks. Control patients will receive standard emergency room education about asthma.
Interventions
BEHAVIORALAsthma Education in Adults
The intervention involves enhancing asthma education, asthma self-efficacy and asthma-related social support and is administered during a single in-person session in the ED (or hospital for admitted patients) followed by telephone reinforcement.
BEHAVIORALStandard Emergency Room Asthma Education
Participants will receive standard emergency room education about asthma.
Sponsors
National Heart, Lung, and Blood Institute (NHLBI)
Hospital for Special Surgery, New York
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* Patients will be eligible if they are 18 years of age or older * Fluent in English * Have a known diagnosis of asthma * Will receive treatment for asthma during the current hospitalization or emergency room visit.
Exclusion criteria
* Cognitive deficits * Other pulmonary diseases or severe comorbidity * Do not have out-patient access to a telephone
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Quality of life | Measured at 8 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Rescue inhaled beta agonist use | Measured at 8 weeks |
| Peak flow meter rates | Measured at 8 weeks |
| Number of days lost from work or school due to asthma | Measured at 8 weeks |
| Decreasing urgent resource utilization for asthma | Measured at 16 weeks and 1 year |
| Cost effectiveness | Measured at 16 weeks and 1 year |
Countries
United States
Outcome results
None listed