Trial of Asthma Patient Education in the Emergency Room

急诊室哮喘患者教育试验

• 批准号: 7006073
• 负责人: Carol A Mancuso
• 金额: $ 42.57万
• 依托单位: HOSPITAL FOR SPECIAL SURGERY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-10 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7006073
• 关键词: absenteeism; adult human (21+); asthma; behavioral /social science research tag; clinical research; clinical trials; cost effectiveness; education evaluation /planning; emergency health services; functional ability; health behavior; health care service evaluation; health care service utilization; health education; health services research tag; human subject; human therapy evaluation; outcomes research; patient oriented research; pulmonary respiration; quality of life; respiratory airflow measurement; respiratory disorder chemotherapy; self help; social support network; stimulant /agonist

DESCRIPTION (provided by applicant): The goals of this study are to translate a successful asthma education program to patients who are treated in the emergency department (ED). This proposal is part of a trajectory of patient-oriented clinical research aimed at improving outcomes in asthma patients. It builds on two prior successful studies. The first, supported by the Robert Wood Johnson Foundation, is a completed study with 224 adult primary care patients that showed that less patient self-efficacy, more depressive symptoms, and unrealistic expectations of treatment predicted deterioration in quality of life and increased urgent resource utilization over 2 years. These findings led to an ongoing NHLBI K23 randomized controlled trial to implement a multi-component education intervention with 180 adult primary care asthma patients. Preliminary results from this trial indicate that this intervention is effective in improving quality of life and urgent resource utilization. Therefore, the specific aim of this proposed randomized controlled trial is to test an intervention to enhance knowledge, self-efficacy and asthma-related social support in 296 adult patients being treated for asthma in two EDs in New York City. The intervention will be administered during a single in-person session in the ED (or hospital for admitted patients) followed by telephone reinforcement. The primary outcome will be the within-patient change in overall Asthma Quality of Life Questionnaire scores from enrollment to 8 weeks. Additional outcomes at 8 and 16 weeks will be the amount of beta agonists used, peak flow rates, work absenteeism, urgent resource utilization, and cost-effectiveness of the program. The novel features of this program are: it is easy to administer; it focuses on ED patients who are in great need of asthma education; and it incorporates self-efficacy, an important aspect of asthma self-management that has not been rigorously tested in ED programs. The long-term objectives are to foster programs in the ED, a setting that has been underserved regarding asthma education, by providing evidence that cost-effective and clinically effective programs can be successfully implemented. Other long-term objectives are to use the program as a basis for similar programs for children, adolescents and their caregivers in the ED, primary care, and school settings.

描述（由申请人提供）：本研究的目的是将成功的哮喘教育计划转化为在急诊科（艾德）接受治疗的患者。该提案是以患者为导向的临床研究轨迹的一部分，旨在改善哮喘患者的结局。它建立在两个先前成功的研究基础上。第一项由罗伯特·伍德约翰逊基金会支持，是一项对224名成年初级保健患者的完整研究，该研究表明，患者自我效能感降低、抑郁症状增加以及对治疗的不切实际的期望预示着生活质量的恶化，并增加了2年内的紧急资源利用。这些发现导致了一项正在进行的NHLBI K23随机对照试验，对180名成人初级保健哮喘患者实施多组分教育干预。这项试验的初步结果表明，这种干预措施在改善生活质量和紧急资源利用方面是有效的。因此，本随机对照试验的具体目的是在纽约市的两个急诊室对296名接受哮喘治疗的成人患者进行干预，以增强知识、自我效能和哮喘相关社会支持。干预将在艾德（或住院患者的医院）的单次面对面会议期间进行，随后进行电话增援。主要结局将是从入组至8周期间哮喘生活质量问卷总体评分的患者内变化。第8周和第16周的其他结果将是β受体激动剂的使用量、峰值流速、缺勤率、紧急资源利用率和计划的成本效益。该计划的新特点是：它易于管理;它侧重于非常需要哮喘教育的艾德患者;它包含了自我效能，这是哮喘自我管理的一个重要方面，尚未在艾德计划中进行严格测试。长期目标是通过提供证据证明可以成功实施具有成本效益和临床有效的计划，在艾德（一个在哮喘教育方面服务不足的环境）促进计划。其他长期目标是将该方案作为艾德、初级保健和学校环境中儿童、青少年及其照顾者的类似方案的基础。