Engaging Patients, Parents, and Teachers to Reduce Pediatric Asthma Hospitalization

10-8-2013 9-55-30 PM

Researchers with the University of Rochester Medical Center are working in collaboration with students, parents, and school administrators at the Rochester School District (NY) to design a community-based telehealth program that will reduce the social and financial costs and associated with pediatric asthma. The CDC lists asthma as the leading chronic illness among children and adolescents in the US, and one of the leading causes of school absenteeism. Rochester School District estimates that as much as 10 percent of its student population has asthma.

"This is all about prevention. Asthma is one of the most common chronic disorders of childhood, and it’s a very high-cost disorder, because parents miss a lot of work because of their child’s asthma, and there are a lot of health care costs associated with it because of emergency visits." – Dr. Jill Halterman, professor of pediatrics at URMC

The program’s core infrastructure is school-based. Children are sent to the nurses office at the start of the school year, where their breathing sounds along with additional clinical information is recorded by a telehealth assistant and transmitted to the community hospital for review by a pediatrician. The students then return to the classroom where for the next six weeks teachers will oversee classroom-based administration of the student’s asthma medication. The goal of this daily interaction is to work with the children to establish good medication adherence habits that might transfer over to home life.

An educational web-based program engages parents in the process, teaching them about pediatric asthma and specifically addressing the effects of second-hand smoke on asthmatic children in households with parental smokers.

At the end of the first six weeks, the student will return to the nurses office for a follow up check in with the telehealth assistant that will recapture the same clinical information that was recorded during the initial visit. This information is transmitted to a pediatrician at the health system who will evaluate it to determine the effectiveness of the current medication regimen. If the current medication dose is not properly suppressing asthma symptoms an adjustment can be made based on the guidance of the remote pediatrician. From this point on, children are returned to the classroom, where they continue receiving classroom-based medication administration and as-needed telehealth checkups throughout the school year. Parents are continually engaged through the web portal.

Earlier research conducted by the same research team, and within the same school system, has already correlated earlier versions of the program with significant increases in symptom-free days for the kids, compared with children in the control group, they also had fewer nighttime symptoms, and less rescue inhaler use.

The new program hopes to establish all of those same benefits and then go on to substantiate a reduction in ED and acute hospital visits for the children. If successful, researchers will publish its findings in the form of a best practice guide detailing how to implement the community-based program.

 


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  • TheMDofTruth

    This brought a smile to my face. I’ve suffered from chronic asthma my entire life. Not only is it extremely expensive to the consumer, it also burdens ER’s and Urgent Care facilities when not properly treated.

    Any word on why Rochester County was selected? Curious if researchers found a particularly high rate of pediatric asthma cases in the area.

  • Lt. Dan

    Hi MDofTruth, the researchers do not specifically mention why Rochester school district was selected. The study was run by the University of Rochester so perhaps it was just convenience. Rochester school district did report that 10% of its students had asthma which places it marginally worse off than the national average.

    Here is a link to the original study in which Rochester was selected, incase you’re interested: http://archpedi.jamanetwork.com/Mobile/article.aspx?articleid=384396

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