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- (-) Asthma (16)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedKrishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Gliklich RE, Castro M, Leavy MB
Harmonized outcome measures for use in asthma patient registries and clinical practice.
The purpose of this project was to develop a minimum set of patient and provider relevant standardized outcome measures that could be collected in asthma patient registries and clinical practice. Categorizing outcome measures using AHRQ’s supported Outcome Measures Framework (OMF), a minimum set of 21 broadly relevant measures from 13 registries was identified. Routine and consistent collection of these measures in registries and in other systems would support creation of a national research infrastructure to efficiently address new questions and improve patient management and outcomes.
AHRQ-funded; 290201400004C.
Citation: Gliklich RE, Castro M, Leavy MB .
Harmonized outcome measures for use in asthma patient registries and clinical practice.
J Allergy Clin Immunol 2019 Sep;144(3):671-81.e1. doi: 10.1016/j.jaci.2019.02.025..
Keywords: Asthma, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Toy D, Braga MS, Greenhawt M
An update on allergic emergencies.
The purpose of this review was to provide an updated framework of management for allergic emergencies. The authors suggest that although fatalities resulting from anaphylaxis and asthma are rare, patient education serves an important role in preparing for unexpected emergencies, instituting prompt and appropriate treatment, and incorporating effective strategies into the lives of children and families.
AHRQ-funded; HS024599.
Citation: Toy D, Braga MS, Greenhawt M .
An update on allergic emergencies.
Curr Opin Pediatr 2019 Jun;31(3):426-32. doi: 10.1097/mop.0000000000000769..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Emergency Department, Patient-Centered Outcomes Research, Evidence-Based Practice
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Lin SY, Azar A, Suarez-Cuervo C
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
This systematic review analyzed a number of studies on sublingual immunotherapy treatment (SLIT) for asthma caused by allergies. Fourteen randomized control trials (RCTs) studies were identified to analyze effective for allergies of house mites, birch, and grasses. However, a total of 20 RCTs and 10 observational studies were identified and used in this review. The review showed moderate-to-high strength evidence that SLIT is effective in improving allergic asthma symptoms. It also reduced long-term medication use and improved FEV1.
AHRQ-funded; 290201500006I.
Citation: Lin SY, Azar A, Suarez-Cuervo C .
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
Int Forum Allergy Rhinol 2018 Sep;8(9):982-92. doi: 10.1002/alr.22152..
Keywords: Asthma, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
Brunwasser SM, Gebretsadik T, Gold DR
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
The authors of this paper developed an easily applicable continuous latent variable model of pediatric wheezing severity based on items from the well-validated International Study of Asthma and Allergies in Children (ISAAC) Wheezing Module. Their model prospectively associates with asthma morbidity, as demonstrated in two ECHO birth cohort studies, and provides a more statistically powerful method of testing etiologic hypotheses of childhood wheezing illness and asthma.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Gebretsadik T, Gold DR .
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
PLoS One 2018 Apr 17;13(4):e0194739. doi: 10.1371/journal.pone.0194739..
Keywords: Asthma, Children/Adolescents, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Sobieraj DM, Weeda ER, Nguyen E
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects of single maintenance and reliever therapy (SMART) in patients with persistent asthma. They found that in patients with persistent asthma, the use of single maintenance and reliever therapy compared with inhaled corticosteroids as the controller therapy (with or without a long-acting beta-agonist) and short-acting beta-agonists as the relief therapy was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Weeda ER, Nguyen E .
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1485-96. doi: 10.1001/jama.2018.2769.
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Keywords: Asthma, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Sobieraj DM, Baker WL, Nguyen E
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects associated with long-acting muscarinic antagonists (LAMAs) vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids. They concluded that use of LAMA compared with placebo as add-on therapy to inhaled corticosteroids was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Baker WL, Nguyen E .
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1473-84. doi: 10.1001/jama.2018.2757.
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Keywords: Asthma, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Palmsten K, Schatz M, Chan PH
Validation of the pregnancy asthma control test.
The researchers sought to validate telephone administration of a modified version of the Asthma Control Test (ACT) during pregnancy. They found that the Pregnancy Asthma Control Test (p-ACT) demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT was reliable and valid for assessing asthma control during pregnancy.
AHRQ-funded; HS018474.
Citation: Palmsten K, Schatz M, Chan PH .
Validation of the pregnancy asthma control test.
J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. doi: 10.1016/j.jaip.2015.11.019.
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Keywords: Pregnancy, Asthma, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research