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哮喘远程医疗教育连接医院与家庭(TEACHH)试点研究

The Telehealth Education for Asthma Connecting Hospital and Home (TEACHH) pilot study.

作者信息

Frey Sean M, Sanchez Ignacio, Fagnano Maria, Milne Wenderlich Andrea, Mammen Jennifer R, Halterman Jill S

机构信息

University of Rochester School of Medicine & Dentistry, Rochester, NY, USA.

University of Massachusetts Dartmouth, Dartmouth, MA, USA.

出版信息

J Asthma. 2025 Mar;62(3):416-426. doi: 10.1080/02770903.2024.2408304. Epub 2024 Oct 9.

Abstract

OBJECTIVE

To evaluate the feasibility of a novel intervention of health literacy-informed, telemedicine-enhanced asthma education and home management support for hospitalized children and caregivers, and assess caregiver perspectives of the intervention.

METHODS

We conducted a pilot randomized trial of the Telehealth Education for Asthma Connecting Hospital and Home (TEACHH) intervention vs. standardized care (SC) for children (5-13 yrs) hospitalized with asthma. Participants in TEACHH received health literacy-informed teaching prior to discharge, including pictorial materials (e.g. flipchart, action plan), color- and shape-coded medication labels, and medication demonstration. Two Zoom-based follow-up teaching visits were completed within 1-month of discharge. Feasibility was assessed by tracking visit completion, and we measured preliminary outcomes using health records (i.e. total asthma-related acute healthcare visits) and blinded surveys of caregivers 2-, 4-, and 6-months post-discharge (i.e. symptom-free days, quality of life). We interviewed caregivers about their perceptions of TEACHH. Transcripts were coded inductively.

RESULTS

We enrolled 26 children and interviewed 14 caregivers (9 TEACHH, 5 SC). All inpatient sessions were completed, as were 77% of virtual visits. Both groups experienced improved symptoms and quality of life over time. Caregivers valued the teaching, involvement of children, visual tools, and color-coded information of TEACHH. They described child-specific benefits, greater support after discharge, and improved asthma-related communication, and indicated that other families would benefit from similar teaching.

CONCLUSIONS

A novel program of patient-centered asthma education was feasible in both hospital and home settings and well received by caregivers. A larger study is needed to assess the impact of TEACHH on childhood asthma morbidity.

CLINICALTRIALS.GOV IDENTIFIER: NCT04995692 (Registration date 8/9/2021).

摘要

目的

评估一种基于健康素养、通过远程医疗加强的哮喘教育及家庭管理支持的新型干预措施对住院儿童及其照顾者的可行性,并评估照顾者对该干预措施的看法。

方法

我们对因哮喘住院的5至13岁儿童开展了一项远程医疗哮喘连接医院与家庭(TEACHH)干预与标准化护理(SC)的试点随机试验。TEACHH的参与者在出院前接受基于健康素养的教学,包括图片材料(如活动挂图、行动计划)、颜色和形状编码的药物标签以及药物示范。出院后1个月内完成了两次基于Zoom的随访教学访问。通过跟踪访问完成情况评估可行性,我们使用健康记录(即与哮喘相关的急性医疗就诊总数)以及出院后2个月、4个月和6个月对照顾者进行的盲法调查(即无症状天数、生活质量)来测量初步结果。我们就照顾者对TEACHH的看法进行了访谈。对访谈记录进行归纳编码。

结果

我们招募了26名儿童,并访谈了14名照顾者(9名TEACHH组,5名SC组)。所有住院课程均已完成,77%的虚拟访问也已完成。随着时间的推移,两组的症状和生活质量均有所改善。照顾者重视TEACHH的教学、儿童的参与、视觉工具以及颜色编码信息。他们描述了针对儿童的益处、出院后获得的更多支持以及与哮喘相关的沟通改善情况,并表示其他家庭也将从类似教学中受益。

结论

一项以患者为中心的哮喘教育新方案在医院和家庭环境中都是可行的,并且受到照顾者的好评。需要进行更大规模的研究来评估TEACHH对儿童哮喘发病率的影响。

临床试验注册号

NCT04995692(注册日期:2021年8月9日)

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