TY - JOUR
T1 - Ambulatory management of childhood asthma using a novel self-management application
AU - Nkoy, Flory L.
AU - Fassl, Bernhard A.
AU - Wilkins, Victoria L.
AU - Johnson, Joseph
AU - Unsicker, Eun Hea
AU - Koopmeiners, Karmella J.
AU - Jensen, Andrea
AU - Frazier, Michelle
AU - Gaddis, Jordan
AU - Malmgren, Lis
AU - Williams, Stacey
AU - Oldroyd, Heather
AU - Greene, Tom
AU - Sheng, Xiaoming
AU - Uchida, Derek A.
AU - Maloney, Christopher G.
AU - Stone, Bryan L.
N1 - Funding Information:
FUNDING: This study was supported by contract IH-12-11-5330 from the Patient-Centered Outcomes Research Institute. The sponsor did not participate in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The contents of this study are solely the responsibility of the authors and do not necessarily represent the official view of the Patient-Centered Outcomes Research Institute.
Publisher Copyright:
Copyright © 2019 by the American Academy of Pediatrics
PY - 2019
Y1 - 2019
N2 - BACKGROUND AND OBJECTIVES: Pediatric ambulatory asthma control is suboptimal, reducing quality of life (QoL) and causing emergency department (ED) and hospital admissions. We assessed the impact of the electronic-AsthmaTracker (e-AT), a self-monitoring application for children with asthma. METHODS: Prospective cohort study with matched controls. Participants were enrolled January 2014 to December 2015 in 11 pediatric clinics for weekly e-AT use for 1 year. Analyses included: (1) longitudinal changes for the child (QoL, asthma control, and interrupted and missed school days) and parents (interrupted and missed work days and satisfaction), (2) comparing ED and hospital admissions and oral corticosteroid (OCS) use pre- and postintervention, and (3) comparing ED and hospital admissions and OCS use between e-AT users and matched controls. RESULTS: A total of 327 children and parents enrolled; e-AT adherence at 12 months was 65%. Compared with baseline, participants had significantly (P, .001) increased QoL, asthma control, and reduced interrupted and missed school and work days at all assessment times. Compared with 1 year preintervention, they had reduced ED and hospital admissions (rate ratio [RR]: 0.68; 95% confidence interval [CI]: 0.49–0.95) and OCS use (RR: 0.74; 95% CI: 0.61–0.91). Parent satisfaction remained high. Compared with matched controls, participants had reduced ED and hospital admissions (RR: 0.41; 95% CI: 0.22–0.75) and OCS use (RR: 0.65; 95% CI: 0.46–0.93). CONCLUSIONS: e-AT use led to high and sustained participation in self-monitoring and improved asthma outcomes. Dissemination of this care model has potential to broadly improve pediatric ambulatory asthma care.
AB - BACKGROUND AND OBJECTIVES: Pediatric ambulatory asthma control is suboptimal, reducing quality of life (QoL) and causing emergency department (ED) and hospital admissions. We assessed the impact of the electronic-AsthmaTracker (e-AT), a self-monitoring application for children with asthma. METHODS: Prospective cohort study with matched controls. Participants were enrolled January 2014 to December 2015 in 11 pediatric clinics for weekly e-AT use for 1 year. Analyses included: (1) longitudinal changes for the child (QoL, asthma control, and interrupted and missed school days) and parents (interrupted and missed work days and satisfaction), (2) comparing ED and hospital admissions and oral corticosteroid (OCS) use pre- and postintervention, and (3) comparing ED and hospital admissions and OCS use between e-AT users and matched controls. RESULTS: A total of 327 children and parents enrolled; e-AT adherence at 12 months was 65%. Compared with baseline, participants had significantly (P, .001) increased QoL, asthma control, and reduced interrupted and missed school and work days at all assessment times. Compared with 1 year preintervention, they had reduced ED and hospital admissions (rate ratio [RR]: 0.68; 95% confidence interval [CI]: 0.49–0.95) and OCS use (RR: 0.74; 95% CI: 0.61–0.91). Parent satisfaction remained high. Compared with matched controls, participants had reduced ED and hospital admissions (RR: 0.41; 95% CI: 0.22–0.75) and OCS use (RR: 0.65; 95% CI: 0.46–0.93). CONCLUSIONS: e-AT use led to high and sustained participation in self-monitoring and improved asthma outcomes. Dissemination of this care model has potential to broadly improve pediatric ambulatory asthma care.
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U2 - 10.1542/peds.2018-1711
DO - 10.1542/peds.2018-1711
M3 - Article
C2 - 31097465
AN - SCOPUS:85067179952
SN - 0031-4005
VL - 143
JO - Pediatrics
JF - Pediatrics
IS - 6
M1 - e20181711
ER -