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Care transition interventions for children with asthma in the emergency department - 18/04/17

Doi : 10.1016/j.jaci.2016.10.012 
Molly A. Martin, MD, MAPP a, , Valerie G. Press, MD, MPH b, Sharmilee M. Nyenhuis, MD a, Jerry A. Krishnan, MD, PhD a, Kim Erwin, MDes c, Giselle Mosnaim, MD d, Helen Margellos-Anast, MPH e, S. Margaret Paik, MD b, Stacy Ignoffo, MSW f, Michael McDermott, MD g
for the

CHICAGO Plan Consortium

a University of Illinois at Chicago, Chicago, Ill 
b University of Chicago, Chicago, Ill 
c Illinois Institute of Technology Institute of Design, Chicago, Ill 
d Rush University Health Center, Chicago, Ill 
e Sinai Health System, Chicago, Ill 
f Chicago Asthma Consortium, Chicago, Ill 
g Illinois Emergency Department Asthma Surveillance Project for the CHICAGO Plan Consortium, Chicago, Ill 

Corresponding author: Molly A. Martin, MD, MAPP, Department of Pediatrics, University of Illinois at Chicago, 840 South Wood St, M/C 856, Chicago, IL 60612.Department of PediatricsUniversity of Illinois at Chicago840 South Wood St, M/C 856ChicagoIL60612

Abstract

The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization. Conducting any ED-based intervention in the current environment is challenging because of the many demands on ED providers and staff, poor communication within and outside of the medical sector, and caregiver/patient burden. The evidence to date suggests that ED care transition interventions should consider expanding beyond the ED to bridge the multiple sectors children with asthma navigate, including health care settings, homes, schools, and community spaces. Patient-centered approaches may also be important to ensure adequate intervention design, enrollment, retention, and evaluation of outcomes important to children and their families.

El texto completo de este artículo está disponible en PDF.

Key words : Asthma, patient-centered, pediatric, emergency department, care transitions, disparities, care coordination, education

Abbreviations used : CAPE, CHICAGO, CHW, ED, PCP


Esquema


 Research reported in this report was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) award (AS-1307-05420, “Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Trial”) and a National Heart, Lung, and Blood Institute/National Institutes of Health grant (grant no. U34 HL130787, “Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Collaboration II”). The statements in this report are solely the responsibility of the authors and do not necessarily represent the views of the PCORI, its Board of Governors, or the Methodology Committee, or the National Institutes of Health.
 Disclosure of potential conflict of interest: M. A. Martin has received grants from the National Institutes of Health and the Patient-Centered Outcomes Research Institute. V. G. Press has received a grant from the Patient-Centered Outcomes Research Institute and the National Heart, Lung, and Blood Institute and has consultant arrangements with Seattle VA, the University of Illinois at Chicago, and the Society of Hospital Medicine COPD Expert Panel. S. M. Nyenhuis has received grants from the Patient-Centered Outcomes Research Institute and the National Heart, Lung, and Blood Institute and is a board member for the Chicago Asthma Consortium. J. A. Krishnan has received a grant and travel support from the Patient-Centered Outcomes Research Institute and has consultant arrangements with Sanofi and the National Heart, Lung, and Blood Institute. K. Erwin has received grants from the Patient-Centered Outcomes Research Institute, the National Institutes of Health, the Knight Foundation, and the Robert Wood Johnson Foundation; has received payment for lectures from Integrated Michigan Patient-centered Alliance for Care Transitions, Western North Carolina Health Network, and OSF Healthcare; has received royalties from Wiley & Sons; and has received travel support from Forechange. G. Mosnaim has received grants from the Patient-Centered Outcomes Research Institute and the National Heart, Lung, and Blood Institute; is a board member for the American Academy of Allergy, Asthma, and Immunology; has consultant arrangements with Teva, GlaxoSmithKline, Boeringher-Ingelheim, and Electrocore, LLC; and has received stock/stock options from Electrocore, LLC. H. Margellos-Anast has received a grant from the Patient-Centered Outcomes Research Institute. S. Ignoffo has received a grant to Chicago Asthma Consortium from the University of Illinois. M. McDermott has received a grant from the Patient-Centered Outcomes Research Institute and has received travel support from the University of Illinois. S. M. Paik declares no relevant conflicts of interest.


© 2016  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 138 - N° 6

P. 1518-1525 - décembre 2016 Regresar al número
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