Topic: be provided further information about the

Topic:Evaluating the effectiveness of remote telephone application’Asthma Action Hero’ intervention to reduce emergency revisits amongadolescents with asthmaHypothesisRemote monitoring of patients through the ‘Asthma ActionHero’ mobile phone application will help adolescent patients better controltheir asthma, thereby reducing emergency visits and improving health outcomesand in the long run, improving their quality of life.  Experimental Design:The objective of this evaluation is to establish that indeedthe use of a mobile phone application ‘Asthma Action Hero’ by adolescent asthmapatients will result in a decrease in emergency visits post-discharge fromhospital. In this case, the independent variable is the use of a mobile phoneapplication, and the dependent variable will be frequency of emergency roomvisits among adolescents with asthma that are enrolled to use ‘Asthma ActionHero’.

As such, several variables to consider for this study will include: 1)data on patients who have downloaded the phone application and clinical followup; 2) engagement with the process- measured through data on actual use of themobile phone application after it has been downloaded; 3) types ofinterventions delivered through the application (i.e. follow up calls byphysicians); 4) number of visits to the emergency room over the course of theyear (i.e. from January 2018 to December 2018). Methods:Recruitment ofsubjectsThe patients recruited would be children ages 12 to 17 yearsadmitted at Children’s Healthcare of Altanta (Scottish Rite) for poorlycontrolled asthma (which can be determined by the use of an asthma controlquestionnaire), and either the patient or the caregiver has a smart phone, andhave indicated willingness to participate in the study (signed consent).Children with major social or clinical problems would be excluded (this wouldbe based on the physicians advise or for patients receiving specialist care).

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Determination of eligibility would be done through a review of medical recordsand if needed consultation with the physician.After an initial screen is done to determine eligibility,potential participants would be invited to participate in a baseline assessmentvisit at which they can be provided further information about the study andeligibility can be confirmed. During this visit, some baseline informationwould also be determined from the patient through a simple assessment (e.

g. asthmahistory, current smoking status, presence of comorbidities, etc.).Proposed DataCollection & AnalysisOutcome measures to be considered are as follows:1.

      Preliminary data on patients who have downloadedthe phone application can be obtained through a clinical follow up; 2.      Subsequent engagement with the process can bemeasured through data on actual use of the mobile phone application after ithas been downloaded3.      Occurrence of adverse events (i.e. acutedeteriorations of asthma for which the patient sought advice from theirphysician) can be obtained from hospital records including unscheduledconsultations, hospital admission due to asthma exacerbations, oradministration of oral steroids, and visits to the emergency room (i.e.

fromJanuary 2018 to December 2018).A researcher would be assigned and blinded to the random allocationof patients who are using the mobile phone application and patients who arereceiving clinical follow up through other means. The researcher will extractdata on adverse events from healthcare resources over the twelve-month study periodand enter them manually into an excel database. Asthma control questionnairedata will be scanned and entered into an excel database. Clinical follow upsfor patients would be done every month to monitor use of the mobileapplication.Analysis:At baseline, the patients will be grouped according to sociodemographicfactors, history of asthma, and responses to the asthma control questionnaire. Acomparison will be drawn on frequency of occurrence of adverse events betweenthe groups of patients using ‘Asthma Action Hero’ and those not using themobile phone application. This outcome will also be compared between theproportion of patients who whose asthma remained poorly controlled based on theAsthma Control Questionnaire versus those whose asthma was “well controlled”.



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