The Coordinated Healthcare Interventions for
Childhood Asthma Gaps in Outcomes (CHICAGO Trial)
Valerie Press, MD, MPH
Assistant Professor, Section of
Hospital Medicine
S. Margaret Paik, MD
Associate Professor of Pediatrics
January 29, 2015
1
2
Aim
Conduct a 3-arm multicenter pragmatic trial
comparing the effectiveness of an enhanced
ED-discharge intervention (CAPE-ED) v.
enhanced ED-discharge combined with a
patient-level CHW-led intervention that
includes a focus on reducing environmental
triggers at home (CAPE-ED plus PatientHome) v. Usual Care.
Asthma Care Action Plan
CAPE
Inclusion Criteria (1 of 2)
1. Children age 5-11 years
2. Presenting to the ED
3. Clinical diagnosis of AE by ED Attending
4. Receiving care in the ED for AE
– at least 1 dose of inhaled short acting
bronchodilator
– at least 1 dose of systemic corticosteroids
Inclusion Criteria (2 of 2)
5. ≥ 1 hour since receiving the first dose of medications
6. ED Attending >75% likely to be dc’d home from ED
7. English or Spanish speaking caregiver/child
8. The patient lives in Chicago
Exclusion Criteria (1 or 2)
1. Discharged from ED to location other than home
– Hospital
– other acute care or chronic care facility
– died prior to ED discharge
2. Caregiver declines to provide informed consent
3. If child ≥7 years old, child declines to provide assent
4. Current or previous participant
– Child/other member of household is in the CHICAGO Trial
Exclusion Criteria (2 of 2)
5. Child is currently enrolled in another research study
involving an intervention for any condition
– observational studies are not an exclusion criterion
6. CHW is expected to conduct ≥1 home visits over 6 mths
to home as part of any other CHW program
7. Child expected to move within next 6 months
8. Caregiver unable/unwilling to provide a valid phone no.
Outcomes
• 2 Co-primary outcomes: Patient/Family- centered
– PROMIS: Asthma Impact Scale (child)
– PROMIS: Satisfaction with social roles (caregiver)
• Secondary outcomes: Adherence to self-management skills:
–
–
–
–
–
–
Child: cACT (childhood Asthma Control Test)
Caregiver: PACQLQ (pediatric asthma caregiver QOL quest)
Acute care visits (all-cause UC visits, ED visits, hospitalizations)
Adherence to meds prescribed in ED (RX filled within 7 days)
Inhaler technique for meds prescribed in ED
Trigger reduction behavior (eg., smoking, roach, mice)
Next Steps
Recruitment starts March 1, 2015!
Our Team
•
•
•
•
•
•
•
[CHICAGO Trial PI: Jerry Krishnan, MD, PhD (UIC)]
Site PI: Valerie Press, MD, MPH
ED co-I: Maggie Paik, MD
Community Health Worker: Brendia Bell
Main ED Coordinator: Nicole Woodrick
ED Coordinator: Ashley Hull
ED Coordinator: John Kim
The CHICAGO Trial Collaborators
Ann & Robert Lurie Children’s Hospital of Chicago. Rush University Medical Center. Sinai Health System. Cook County
Health & Hospital System (Stroger). University of Illinois Hospital & Health Sciences System (UI-Health). University of
Illinois – Chicago (UIC). Chicago Asthma Consortium (CAC). Respiratory Health Association (RHA). NorthShore University
HealthSystem (NSUHS). Northwestern University (NWU). Illinois Emergency Department Asthma Surveillance Project
(IEDASP). Chicago Department of Public Health (CDPH). Illinois Institute of Technology (IIT).
8 PCORI awards: Treatment options for African American
and Latinos / Hispanics with uncontrolled asthma
Alex Federman, Icahn
SOM at Mt. Sinai
James Krieger,
Seattle-King County
Pub Health Dept
Kaharu Sumino,
WashU
Andrea Apter,
UPenn
Stephen Teach, Children’s
Research Institute
John Elder, San Diego
State Univ
Winifred Hamilton,
BCM
December 17, 2013 - PCORI Announces Research Awards: Congratulations!