Program Analyst UCLA UCLA Los Angeles, California, United States
Background: More than half of children seen in the Emergency Department (ED) for asthma do not have primary care follow-up within 30 days, despite national asthma guideline recommendations. Text messaging (“text”) may help provide more coordinated and continuous asthma care.
Objective: 1) Evaluate whether and how parents respond to receiving a text survey that assesses morbidity of their child following an ED visit for asthma. 2) Estimate likelihood of text message response by sociodemographic and clinical characteristics.
Design/Methods: A research assistant enrolled parents of children 2-17 years of age presenting for ED asthma care to collect baseline sociodemographic and clinical information. One month after enrolment, parents received a 22-item survey by text (in English or Spanish) that included an asthma control questionnaire (the Pediatric Asthma Control and Communication Instrument, PACCI). The text was resent up to 8 times to non-responders. A bivariate comparison of responders and non-responders for sociodemographic and clinical characteristics was conducted. Multivariate logistic regressions (MLR) were carried out with a subset of characteristics, with three survey outcome variables—respondents who answered: - i) ≥1 question; ii) ≥ 80% of questions iii) all 5 PACCI asthma control questions.
Results: Of 173 parent participants: 55%, answered at least one question; 71% of responders answered >18 items; and 84% answered all five PACCI questions. Response to at least one question was significantly related to baseline sociodemographic and clinical characteristics (Table 1). Parents who answered 18+ items and all 5 PACCI items were also more likely to have a child who had previously taken an oral steroid (Table 1). On the 1-month follow-up text survey, most parents reported improved asthma, but nearly half of children had uncontrolled asthma and more than 25% still had significant asthma morbidity (Table 2). Parental education was significant in all 3 MLR models, while oral steroid use during the previous 12 months was significant in two of three MLR models (Table 1). Conclusion(s): A high proportion of parents who previously sought care for their child’s asthma in the ED completed a 1-month follow-up text survey to assess their child’s asthma morbidity. This suggests that texting may be a reasonable strategy to both engage patients for asthma follow-up and to assess the need for enhanced asthma care.
Authors/Institutions: Frances Barry, UCLA, Los Angeles, California, United States; Lindsey R. Thompson, Kaiser Permanente, Oakland, California, United States; Bahareh Ravandi, Children's Hospital Los Angeles, Los Angeles, California, United States; Todd Chang, Children's Hospital Los Angeles, Los Angeles, California, United States; Jill Halterman, University of Rochester School of Medicine, Rochester, New York, United States; Peter G. Szilagyi, UCLA School of Medicine, Los Angeles, California, United States; Sande Okelo, UCLA, Los Angeles, California, United States