Telephone coaching for parents of children with asthma: impact and lessons learned.
OBJECTIVE
To determine whether an asthma coaching program can improve parent and child asthma-related quality of life (QOL) and reduce urgent care events.


METHODS
Randomized controlled trial of usual care vs usual care with coaching. Comparisons were made between groups using mixed models.


METHODS
A Midwest city.


METHODS
A community-based sample of 362 families with a child aged 5 to 12 years with persistent asthma.


METHODS
A 12-month structured telephone coaching program in which trained coaches provided education and support to parents for 4 key asthma management behaviors.


METHODS
Parental and child QOL measured with a validated, interview-administered, 7-point instrument and urgent care events in a year (unscheduled office visits, after-hours calls, emergency department visits, or hospitalizations) determined by record audit.


RESULTS
Parental asthma-related QOL scores improved by an average of 0.67 units (95% confidence interval [CI], 0.49 to 0.84) in the intervention group and 0.28 units (95% CI, 0.10 to 0.46) in the control group. The difference between study groups was statistically significant (difference, 0.38; 95% CI, 0.14 to 0.63). No between-group difference was found in the change in the child's QOL (difference, -0.17; 95% CI, -0.47 to 0.12) or in the mean number of urgent care events per year (difference, 1.15; 95% CI, 0.82 to 1.61). The proportion of children with very poorly controlled asthma in the intervention group decreased compared with the control group (difference, 0.34; 95% CI, 0.21 to 0.48).


CONCLUSIONS
A telephone coaching program can improve parental QOL and can be implemented without additional physician training or practice redesign.
Garbutt
Jane M
JM
Department of Medicine, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA. jgarbutt@dom.wustl.edu
Banister
Christina
C
Highstein
Gabrielle
G
Sterkel
Randall
R
Epstein
Jay
J
Bruns
Julie
J
Swerczek
Lisa
L
Wells
Suzanne
S
Waterman
Brian
B
Strunk
Robert C
RC
Bloomberg
Gordon R
GR
D000553:Ambulatory Care / Q000706:statistics & numerical data; D001249:Asthma / Q000628:therapy*; D002648:Child; D006801:Humans; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education*; D015397:Program Evaluation; D011788:Quality of Life; D013689:Telephone