Randomized trial of the feasibility of ED-initiated school-based asthma medication supervision (ED-SAMS).
Randomized trial of the feasibility of ED-initiated school-based asthma medication supervision (ED-SAMS).
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DOI：
10.1186/s40814-021-00913-0
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发表时间：
2021-09-27
影响因子：
1.7
通讯作者：
Denninghoff K
中科院分区：
文献类型：
--
作者：
Gerald LB;Gerald JK;VanBuren JM;Lowe A;Guthrie CC;Klein EJ;Morrison A;Startup E;Denninghoff K
虽然在艾德就诊后的几周内使用吸入性皮质类固醇（ICS）减少了重复就诊，但很少有儿童接受所需的处方。由于处方可能无法填写或使用，在出院时分发ICS并监督其在学校的使用可以克服这两个障碍，直到建立后续护理。为了评估这种干预的可行性，我们在哮喘急性发作后从艾德出院的持续性哮喘小学学龄儿童中进行了一项试点研究。符合条件的儿童被随机分配到ED分配ICS与家庭监督或ED分配ICS与家庭和学校监督。主要结果是招募和留住参与者的能力，在出院后5天内开始学校监督的药物管理的能力，以及参与者的满意度。尽管确定了437名可能符合条件的儿童，但只有13名（3%）被招募，其中6名被随机分配到干预组，7名被随机分配到对照组。11名（85%）随机化受试者完成了90天访谈（主要结局），8名（62%）完成了120天访谈（安全性终点）。4名（67%）干预参与者在5个工作日内开始了他们的学校方案，2名在6个工作日内开始。虽然我们的试点研究没有达到招募目标，但它确实达到了在进行更大规模、更深入的研究之前评估可行性的主要目的。在ED能够成功地与学校合作建立监督ICS治疗之前，需要减轻几个主要的招聘障碍。ClinicalTrials.gov，NCT 03952286。已于2019年5月16日注册，
While using an inhaled corticosteroid (ICS) in the weeks after an ED visit reduces repeat visits, few children receive a needed prescription. Because a prescription may not be filled or used, dispensing ICS at discharge and supervising its use at school could overcome both barriers until follow-up care is established. To assess the feasibility of such an intervention, we conducted a pilot study among elementary-age school children with persistent asthma who were discharged from the ED following an asthma exacerbation. Eligible children were randomly assigned to ED-dispensing of ICS with home supervision or ED-dispensing of ICS with home and school supervision. The primary outcomes were ability to recruit and retain participants, ability to initiate school-supervised medication administration within 5 days of discharge, and participant satisfaction. Despite identifying 437 potentially eligible children, only 13 (3%) were enrolled with 6 being randomized to the intervention group and 7 to the control group. Eleven (85%) randomized participants completed the 90-day interview (primary outcome) and 8 (62%) completed the 120-day interview (safety endpoint). Four (67%) intervention participants started their school regimen within 5 business days and 2 started within 6 business days. While our pilot study did not meet its recruitment goal, it did achieve its primary purpose of assessing feasibility before undertaking a larger, more intensive study. Several major recruitment barriers need to be mitigated before EDs can successfully partner with schools to establish supervised ICS treatment. ClinicalTrials.gov, NCT03952286. Registered 16 May 2019,