Telehealth delivery of adherence and medication management system improves outcomes in inner-city children with asthma.
Telehealth delivery of adherence and medication management system improves outcomes in inner-city children with asthma.
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DOI：
10.1002/ppul.24623
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发表时间：
2020-04
影响因子：
3.1
通讯作者：
Guilbert, Theresa W.
中科院分区：
文献类型：
--
作者：
Lin, Nancy Y.;Ramsey, Rachelle R.;Miller, James L.;McDowell, Karen M.;Zhang, Nanhua;Hommel, Kevin;Guilbert, Theresa W.
美国儿童哮喘存在医疗保健差异。内城区少数民族、低收入家庭的儿童在获得医疗保健方面遇到障碍，导致哮喘控制不佳和医疗保健利用率更高。找到一种有效的方法为这一服务不足的人群提供高质量的医疗保健，以改善结果、降低发病率和死亡率并减少医疗保健利用率至关重要。本研究的目的是评估一种新型的基于学校的护理服务模式的可行性和有效性，该模式将基于视频的远程医疗 (VBT) 医疗和自我管理就诊与电子吸入器监测相结合，以改善哮喘结果。在 6 个月的时间里，来自市中心低收入学校的哮喘未得到控制的儿童使用 VBT 完成了 7 次定期的哮喘专家就诊和 5 次学校依从性心理学家的自我管理就诊。记录并分析综合哮喘严重程度指数（CASI）评分和电子吸入器监测数据。共有 21 名患者参加了该研究。基线严重程度较高的研究对象（第 1 次访视时 CASI ≥ 4）比基线严重程度较低的研究对象（第 1 次访视时 CASI < 4）表现出更大的评分下降。 CASI 域显示白天症状、夜间症状和恶化情况有所改善。依从性结果表明，从基线到干预后，依从性显着改善。学习保留率为 100%。这项研究表明，VBT 在学校环境中提供的多成分医疗和行为干预计划是可行的，并且可以显着改善具有挑战性的人群的哮喘结果和护理。
Healthcare disparities exist in pediatric asthma in the United States. Children from minority, low‐income families in inner‐city areas encounter barriers to healthcare, leading to greater rates of poorly controlled asthma and healthcare utilization. Finding an effective way to deliver high‐quality healthcare to this underserved population to improve outcomes, reduce morbidity and mortality, and reduce healthcare utilization is of the utmost importance. The purpose of this study was to assess the feasibility and efficacy of a novel school‐based care delivery model that incorporates video‐based telehealth (VBT) medical and self‐management visits with electronic inhaler monitoring to improve asthma outcomes. Over a 6‐month period, children from inner‐city, low‐income schools with uncontrolled asthma completed seven scheduled medical visits with an asthma specialist and five self‐management visits with an adherence psychologist at school using VBT. Composite Asthma Severity Index (CASI) scores and electronic inhaler monitor data were recorded and analyzed. A total of 21 patients were enrolled in the study. Study subjects with higher baseline severity (CASI ≥ 4 at visit 1) demonstrated a greater reduction in their score than those with lower baseline severity (CASI < 4 at visit 1). The CASI domains showed improvement in daytime symptoms, nighttime symptoms, and exacerbations. Adherence results demonstrated a significant improvement in adherence from baseline to postintervention. Study retention was 100%. This study demonstrates that a multicomponent medical and behavioral interventional program delivered by VBT to a school‐based setting is feasible and can significantly improve asthma outcomes and care in a challenging population.
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DOI：
10.1164/rccm.200308-1178oc
发表时间：
2004-08-15
影响因子：
24.7
作者：
Bacharier, LB;Strunk, RC;Sorkness, CA
通讯作者：
Sorkness, CA
影响因子：
26.1
作者：
Halterman, Jill S.;Fagnano, Maria;McConnochie, Kenneth M.
通讯作者：
McConnochie, Kenneth M.
影响因子：
3.3
作者：
Mansour, Mona E.;Rose, Barbara;Atherton, Harry D.
通讯作者：
Atherton, Harry D.
影响因子：
5.1
作者：
Evans, R;Gergen, PJ;Wedner, HJ
通讯作者：
Wedner, HJ
影响因子：
9.7
作者：
Kvedar, Joseph;Coye, Molly Joel;Everett, Wendy
通讯作者：
Everett, Wendy