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Telehealth-Enhanced Asthma Care for Home After the Emergency Room

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

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
3 Years to 12 Years
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Procedures mentioned: Questionnaires

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "The investigators will call caregivers to complete blinded follow-up telephone surveys at 3, 6, 9, and 12 months after discharge."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests whether asthma teaching and video visits at home help reduce emergency room visits and hospital stays compared with enhanced care. It is for children ages 3–12 who visit the emergency room for asthma and need daily medicine to control it. Children will be followed for 12 months.

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.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Have asthma diagnosed by a doctor, based on medical records or a caregiver’s report.
  • Be at the emergency room for an asthma flare-up that needs quick-relief medicine.
  • Need daily asthma control medicine and meet at least one of the symptom or treatment rules below.
  • Have symptoms or use quick-relief medicine more than 2 days a week in the past month; OR have nighttime symptoms more than 2 nights in the past month (1–2 nights for ages 3–4).
  • OR have had at least one other asthma flare-up needing steroid medicine taken by mouth or shot in the past year (past 6 months for ages 3–4).
  • Be 3–12 years old.
  • Child and caregiver must live in Monroe, Wayne, Ontario, Livingston, Genesee, or Orleans County in the Rochester, NY area.
  • Have an emergency room urgency score of 2–5. A score of 1 means the most urgent care is needed.

Who can't join

  • Cannot speak and understand English. Trouble reading or understanding health information does not prevent joining.
  • Have no working phone at home or nearby for follow-up calls. The study will provide a device and data plan if needed for home video visits.
  • Have another major health condition that could affect asthma checks, such as cystic fibrosis, heart disease present at birth, or another long-term lung disease.
  • Be in foster care or another situation where a legal guardian cannot give permission.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria (all criteria must be met): * Physician diagnosis of asthma, based on review of medical records and/or caregiver report. * Current emergency visit for an acute asthma exacerbation, requiring treatment with rescue medication. * Persistent asthma or poor asthma control for which a daily controller medication is recommended by NHLBI guidelines, defined as any 1 of the following: 1. \>2 days/wk with asthma symptoms in the past month, 2. \>2 days/wk with rescue medication use in the past month, 3. \>2 days/month with nighttime symptoms in the past month (vs. 1-2 nights per month if 3-4 years old), or 4. ≥1 other episode of asthma during the past year that required systemic corticosteroids (vs. during the past 6 months if 3-4 years old). * Child age between ≥3 and ≤12 years. * Child and caregiver live in the greater Rochester, NY metropolitan area (Monroe, Wayne, Ontario, Livingston, Genesee, and Orleans Counties) * Emergency severity index triage scores of 2-5 (total range 1-5; scores of 1 indicate the highest acuity and likelihood of hospitalization). Exclusion Criteria: * An inability to speak and understand English. Parents (and children) with low literacy / health-literacy skills will be eligible, as survey instruments will be administered verbally and educational materials will be designed for low-literacy populations. * No access to a working phone for follow-up surveys (either at the subject's home or an easily accessible location). If a subject does not have access to an appropriate device for Zoom visits at home, we will provide a device with required data plan. * Other significant medical conditions, including cystic fibrosis, congenital heart disease, or other chronic lung disease, that could interfere with the assessment of asthma-related measures. * Children in foster care or other situations in which consent cannot be obtained from a legal guardian.

Study sites (1)

NY