Asthma Clinical Trial
Official title:
Optimizing Discharge After Emergency Department Visits for Children With Uncontrolled Asthma
Many children have asthma and this causes problems with their health. A lot of children with
uncontrolled asthma use emergency departments for asthma care, and so this is an ideal place
for an intervention for these children. One intervention is prescribing inhaled steroids to
children with uncontrolled asthma, but currently this is rarely done in the emergency
department. Inhaled steroids have been shown to be good at making children better long-term
when they have uncontrolled asthma.
This study identifies children in the emergency department with uncontrolled asthma using a
tool called the Pediatric Asthma Control and Communication Instrument (PACCI). If children
meet criteria for uncontrolled asthma they will be randomly assigned to either: 1) routine
asthma care which includes close follow up with their doctor or 2) prescribing of an inhaled
corticosteroid from the emergency department. The investigators hypothesize that children who
are prescribed inhaled steroids for uncontrolled asthma from the emergency department will
have better 6 month asthma control than children who receive routine asthma care.
Specific aim 1 - An ED-based RCT to determine if ICS prescription in children identified
using the PACCI as having uncontrolled asthma results in less asthma morbidity compared to
routine asthma care. We hypothesize that children receiving ICS prescriptions will have fewer
unscheduled health care use for asthma exacerbations (doctor's office visits, ED visits, or
hospitalizations), and greater quality of life.
Specific aim 2 - Thematic analysis of interviews with parents who are adherent versus
non-adherent with ICS prescription filling and use to determine the factors associated with
adherence. We hypothesize that factors will include: 1) Parent beliefs about the chronic
versus episodic nature of asthma, 2) Parent's knowledge of benefits and risks of ICS, and 3)
Provision and use of an asthma action plan.
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