4.7 Article

Care transition interventions for children with asthma in the emergency department

期刊

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 138, 期 6, 页码 1518-1525

出版社

MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2016.10.012

关键词

Asthma; patient-centered; pediatric; emergency department; care transitions; disparities; care coordination; education

资金

  1. Patient-Centered Outcomes Research Institute (PCORI) award [AS-1307-05420]
  2. National Heart, Lung, and Blood Institute/National Institutes of Health [U34 HL130787]

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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.

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