Chest
Original ResearchRandomized Controlled Trial of Emergency Department Interventions To Improve Primary Care Follow-up for Patients With Acute Asthma
Section snippets
Setting and Study Design
We performed a randomized controlled trial from October 2000 to March 2002. Investigators at nine EDs chosen for geographic and patient diversity screened and enrolled patients for a median of 6 weeks. Enrollment periods were not simultaneous across sites. Each site chose a convenient time to begin the trial; once targeted enrollment was reached, no new patients were recruited. However, follow-up procedures continued for each enrolled patient for 12 months. The majority of sites were tertiary
Results
During the study, 1,067 patients were evaluated for acute asthma. A review of the logs identified 75 patients who were ineligible. Of the remaining 992 patients, 91 refused to participate and 517 were missed, leaving 384 patients who were eligible and enrolled (126 patients in group A, 126 patients in group B, and 132 patients in group C) [Fig 1]. Although eligible patients who were not enrolled were slightly older than those who were enrolled (25 years vs 23 years) and were more likely to be
Discussion
This randomized controlled multicenter trial found that the intervention that included an already scheduled appointment increased 30-day follow-up visits with a PCP compared to the intervention that only utilized a telephone reminder and compared to usual discharge care. The difference in primary care follow-up between the intervention group given appointments (group C) and the other two groups remained statistically significant even after adjustment for other factors associated with enhanced
Emergency Medicine Network Steering Committee
Edwin D. Boudreaux, PhD; Barry E. Brenner, MD, PhD; Carlos A. Camargo, Jr, MD (Chair); Rita K. Cydulka, MD; Theodore J. Gaeta, DO, MPH; and Michael S. Radeos, MD, MPH.
Emergency Medicine Network Coordinating Center
Carlos A. Camargo, Jr, MD (Chair); Sunday Clark, MPH; Jennifer A. Emond, MS; Jessica L. Hohrmann, MPH; Gabrielle C. Hunter; Sunghye Kim, MD; and Michael S. Radeos, MD; all at Massachusetts General Hospital, Boston.
Principal Investigators at the Nine Participating Sites
Jill M. Baren, MD (Children's Hospital of Philadelphia and Hospital of the University of Pennsylvania, Philadelphia,
ACKNOWLEDGMENT
We thank the Emergency Medicine Network Investigators for their ongoing dedication to emergency airway research.
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Presented in abstract form at the Annual Meeting of The Society for Academic Emergency Medicine, St. Louis, MO, May 2002.
This project was supported by an Emergency Medicine Foundation Center of Excellence Award (Dallas, TX).
Dr. Rowe is supported by the CIHR as a Canada Research Chair (Ottawa, ON). Ms. Clark is supported by grant T32 ES07069, and Dr. Camargo by grant R01 HL63841 from the National Institutes of Health (Bethesda, MD).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).