NEBULIZER INTERVENTION IN MINORITY CHILDREN WITH ASTHMA

描述：患有哮喘的低收入少数民族儿童有不成比例的 急诊科使用率高与医院护理使用率比较 对其他孩子来说。及早准确识别与哮喘症状有关的 及时和适当地使用哮喘药物与减少 艾德来访。在幼儿中，适当的药物使用包括准确的 症状感知和雾化吸入使用。在一项针对低收入少数民族的试点研究中 我们观察到患有症状性哮喘的儿童过度使用家庭喷雾器(48 %)，未充分使用带有间隔物的计量吸入器(2.7%)和 峰值流量计(17%)。这项研究旨在确定一项 强化家庭雾化器教育干预(NEI)将与 目标1：降低哮喘发病率，目标2改善父母和儿童哮喘症状 识别；目标3：增强适当的雾化用药依从性和 目标4：与入学的儿童相比，展示成本效益 标准哮喘教育干预(SAE)。急诊科就诊的差异 哮喘、住院天数、紧急和初级保健就诊次数、学校 缺勤、活动受限、夜间症状、功能状态、质量 随访18个月以上的生命在两组之间进行比较(NEI 和SAE)。约翰霍普金斯大学教育学院将作为我们的招聘网站。的家庭 患有中重度哮喘的儿童，年龄2-8岁(N=220)。 在过去12个月中因哮喘就诊或住院治疗 目前正在使用喷雾器的人将被录取。数据分析将包括 卡方检验、t检验、方差分析和多元线性回归模型。这个 将使用广义估计方程(GEE)来处理这种相关性 反复采取措施。成本效益和成本效益比率将是 为了检查不同群体之间护理费用的差异而生成的。学习 结果将提供关于NEI干预的影响的重要数据 中度到重度哮喘的儿童，干预的相对成本， 以及满足中度肥胖儿童需求所需的主要组成部分 严重的哮喘。研究结果将改善对这一弱势群体的临床护理 儿童人口，如果对卫生保健提供者有重大用处， 研究人员、保险公司和政策制定者。

DESCRIPTION: Low-income minority children with asthma have disproportionately high utilization rates o f emergency department (ED) and hospital care compared to other children. Early and accurate identification of asthma symptoms linked with timely and appropriate asthma medication use is associated with decreased ED visits. In young children appropriate medication use includes accurate symptom perception and nebulizer use. In a pilot study of low-income minority children with symptomatic asthma we observed overuse of home nebulizer (48 percent), underuse of metered dose inhaler (MDI) with spacers (2.7 percent) and peak flow meter (17 percent). This study is designed to determine if an intensive home Nebulizer Education Intervention (NEI) will be associated with Aim 1: reduced asthma morbidity, Aim 2 improved parent and child asthma symptom identification; Aim 3: enhanced appropriate nebulizer medication adherence and Aim 4: demonstrate cost effectiveness as compared to children enrolled in a standard asthma education intervention (SAE). Difference in ED visits for asthma, hospital days, number of urgent and primary care visits, school absences, restricted activity, nighttime symptoms, functional status, quality of life over 18 month follow-up will be compared between the two groups (NEI and SAE). The Johns Hopkins ED will serve as our recruitment site. Families of children with moderate-severe asthma, ages 2-8 years (N = 220) with > 1 emergency room visit or a hospitalization for asthma care in the past 12 months and currently using a nebulizer will be enrolled. Data analysis will include chi square test, t-tests, ANOVA, and multivariate linear regression models. The Generalized Estimating Equation (GEE) will be used to address the correlation of repeated measures. Cost-effectiveness and cost benefit ratios will be generated to examine for differences in cost of care between groups. Study outcomes will provide important data on the effects of a NEI intervention for children with moderate to severe asthma, the relative cost of the intervention, and the major components required to meet the needs of children with moderate to severe asthma. Study findings will improve clinical care to this vulnerable population of children and will be if significant use to health care providers, researchers, insurers and policy makers.