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Purpose

This study is testing a new way to help adults with asthma get follow up care after an emergency room (ER) visit for an asthma attack. Many people who come to the ER for asthma never see an asthma specialist afterward, even though specialists can offer treatments such as advanced inhalers or biologic medicines that may prevent future attacks. The study will compare two approaches. One group will receive a telehealth appointment with an asthma specialist that is scheduled for them before they leave the ER. The other group will receive the usual care, which typically includes a standard referral but no scheduled appointment. All participants will be offered a prescription for standard controller medication at discharge. The main question the study aims to answer is whether arranging a telehealth visit directly from the ER increases the number of patients who complete a follow up appointment with an asthma specialist within three months. The study will also look at whether this approach improves asthma control, reduces repeat ER visits, and helps patients better understand and use their asthma medications. This research may help identify a practical way to improve access to asthma specialists and reduce the burden of asthma for patients who frequently rely on emergency care.

Conditions

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Age ≥18 years - Asthma diagnosis ≥1 year - Seen in ER for asthma exacerbation - Persistent asthma on controller therapy - ≥1 asthma exacerbation in prior year

Exclusion Criteria

  • Patients who have seen an asthma specialist (allergist or pulmonologist) for asthma in the past 1 year - Diagnosis of other pulmonary diseases (e.g., COPD, interstitial lung disease, etc.) We will allow for current smokers, vapers and cannabis users as long as they meet one of the COPD-allowable pathways below. COPD-allowable pathways: If none of the below are satisfied, then exclude for COPD. Documentation: PFTs must be within 36 months of enrollment date; smoking history must be calculated and entered in this form based on patient input. Pack- year history will be collected for characterization/analysis but will not determineeligibility. We will allow for COPD as long as they are: - never smokers/vapers/cannabis users; - former or current smokers/vapers/cannabis users with normal PFTs with FEV1/FVC >=70% documented in a medical record within 36 months of the enrollment date - former or current smoker/vapers/cannabis users with obstruction noted on PFTs (i.e., FEV1/FVC <70%) but who demonstrates BOTH acute bronchodilator reversibility (i.e., >10% increase in either FEV1%predicted or FVC% predicted) AND have a normal diffusing capacity (DLCO)

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Intervention Arm 		Participants will receive two components: 1. Emergency Room (ER) staff will directly contact the asthma specialist's scheduling team to arrange a follow-up appointment within 1-3 weeks. 2. The follow-up appointment will be conducted via telehealth (including phone calls) to assess follow-up care and asthma control of all participants. Both Arms: • All participants will be offered a prescription for twice-daily ICS/LABA (fluticasone/salmeterol) controller therapy at ER discharge after signing informed consent. These medications are standard of care for asthma. Asthma-related surveys and study-specific questionnaires, "medication side effects (open-ended)" and "follow-up care questions" will be administered during the ER visit and again at the 3-month follow-up phone call.
  • Behavioral: ER-Initiated Telehealth Referral
    Participants assigned to the intervention arm will receive an asthma specialist follow up appointment that is scheduled directly from the emergency department before discharge. Emergency department staff will contact the specialist clinic to arrange a telehealth visit within 1-3 weeks. The telehealth visit will address asthma symptoms, medication use, and follow-up care needs. All participants, including those in the intervention arm, will be offered a prescription for standard inhaled corticosteroid/long-acting beta-agonist controller therapy at discharge. The intervention focuses on improving access to specialist care through proactive scheduling and telehealth delivery.
No Intervention
Usual Care Arm 		Participants will receive an EMR-based referral to an outpatient allergy clinic, with the option of a telehealth or in-person visit at their discretion. This referral will be offered during the 3-month follow-up phone call to ensure clinical equipoise. Both Arms: • All participants will be offered a prescription for twice-daily ICS/LABA (fluticasone/salmeterol) controller therapy at ER discharge after signing informed consent. These medications are standard of care for asthma. Asthma-related surveys and study-specific questionnaires, "medication side effects (open-ended)" and "follow-up care questions" will be administered during the ER visit and again at the 3-month follow-up phone call.

Recruiting Locations

Tampa General Hospital Emergency Room
Tampa, Florida 33606
Contact:
Hope Brunner, RN, BSN
813-844-7289
hbrunner@tgh.org

More Details

Status
Recruiting
Sponsor
Juan Carlos Cardet

Study Contact

Amanda McNamara, BA, LPN
813-396-2729
Alett1@usf.edu

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.