Use of Text Messages to Improve Care For Children Following an ED Visit for Asthma

Asthma Clinical Trial

Official title:

Use of Text Messages to Improve Care For Children Following an ED Visit for Asthma

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT02436070
• Other study ID #: 1409-082
• Status: Recruiting
• Phase: N/A
• First received: May 1, 2015
• Last updated: November 20, 2017
• Start date: October 2014
• Est. completion date: December 2018

Study information

• Verified date: November 2017
• Source: Children's Hospitals and Clinics of Minnesota
• Contact: Heidi Vander Velden
• Phone: 6128137892
• Email: heidi.vandervelden[@]childrensmn.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

BACKGROUND Asthma is a prevalent and troublesome pediatric condition. In 2013, Emergency Department (ED) providers treated over 3,500 cases of asthma-related complaints at Children's Hospitals and Clinics of Minnesota. Pediatric ED visits for asthma exceeds billions of dollars annually when including direct cost and lost productivity. Many of these visits and resultant costs are avoidable. Patients with well-controlled asthma do not typically exhibit these patterns, while patients with poorly controlled asthma show patterns of increased utilization of healthcare resources and lower quality of life. Evidence suggests that a text message reminder and educational program might positively influence pediatric asthma care practices.

RESEARCH QUESTION Does a targeted ED based text message intervention program improve outpatient follow-up and routine preventive care in pediatric asthma patients?

METHODS Study subjects will be block randomized based on age and insurance group. The experimental group will receive text messages with guidance towards follow-up care with their PCP and the importance of the flu vaccine for children with asthma. The control group will receive a series of educational self-care and health based text messages unrelated to asthma or the flu vaccine. Some self-report of behaviors will be captured via text message response.

ANALYSIS Primary outcomes for the educational versus targeted text message groups will be compared use Chi-square tests. Additional adjustments may be applied for missing data or if, despite randomization, there is substantial imbalance between group in key covariates (eg race/ethnicity, insurance type or asthma severity.)

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 195
• Est. completion date: December 2018
• Est. primary completion date: December 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 4 Years to 17 Years

Eligibility

Inclusion Criteria:

• Caregivers of patients aged 4 - 17 years (inclusive) will be eligible for study participation if they meet the following criteria:

1. Presentation to the ED with a chief complaint related to an asthma exacerbation such as shortness of breath, respiratory distress, wheezing, etc…

2. Receive an albuterol treatment in the ED

3. Previous history of asthma as represented in the medical record or by parental report

4. Have a cell phone that is able to receive text messages

5. Able to communicate and provide consent in English or Spanish

Exclusion Criteria:

• Caregivers of patients will be excluded from this study for the following reasons:

1. First episode of wheezing

2. Admitted to the hospital

3. Co-morbid respiratory disease:

1. Cystic fibrosis

2. Bronchiectasis

3. Pulmonary hypertension

4. Other chronic lung disease

4. Current cancer diagnosis

5. Previous cardiovascular surgery

6. Inflammatory bowel disease

7. Sickle Cell disease

Related Conditions & MeSH terms

• Asthma

Intervention

Behavioral:
• Targeted text messages
Subjects received text messages specific to post ED asthma follow-up
• General text messages
Subjects received text messages generalized to children with asthma

Locations

Country	Name	City	State
United States	Children's Hospitals and Clinics of Minnesota - Emergency Department	Minneapolis	Minnesota
United States	Children's Minnesota	Saint Paul	Minnesota

Sponsors (2)

Lead Sponsor	Collaborator
Children's Hospitals and Clinics of Minnesota	HealthPartners Institute

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Follow-up care with primary care provider	Assessed via text and follow-up call if no response to text message	1 week after emergency department discharge
Secondary	Influenza vaccine	Assessed via text and follow-up call if no response to text message	30 days after emergency department discharge
Secondary	Return visit to the emergency department	Assessed via text and follow-up call if no response to text message; Our health record also checked for return visits	30 days after the inaugural emergency department visit