williaM J. galuSh, ankit r. patel, Michael adler, ulrike altenburger, ulla grauSchopF, pierre goldbach, JonaS l. FaSt, irene kräMer, and hannS-chriStian Mahler Am J Health-Syst Pharm. 2015; 72:396-407
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.
What was the research about? Asthma is the most common chronic illness among children in the United States. Asthma attacks can cause children to miss school and their parents to miss work. Children and their families being aware of asthma symptoms and changing treatments when asthma gets worse may help prevent severe attacks. This study had two parts. In the first part, the research team compared two versions of an electronic asthma tracker. The tracker is a web-based program that helps families check children's asthma symptoms over time.
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