title: Care transition interventions for children with asthma in the emergency department.
abstract: The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization. Conducting any ED-based intervention in the current environment is challenging because of the many demands on ED providers and staff, poor communication within and outside of the medical sector, and caregiver/patient burden. The evidence to date suggests that ED care transition interventions should consider expanding beyond the ED to bridge the multiple sectors children with asthma navigate, including health care settings, homes, schools, and community spaces. Patient-centered approaches may also be important to ensure adequate intervention design, enrollment, retention, and evaluation of outcomes important to children and their families.
authors.affiliation: University of Illinois at Chicago, Chicago, Ill. Electronic address: mollyma@uic.edu.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Martin
authors.affiliation: University of Chicago, Chicago, Ill.
authors.forename: Valerie G
authors.initials: VG
authors.lastname: Press
authors.affiliation: University of Illinois at Chicago, Chicago, Ill.
authors.forename: Sharmilee M
authors.initials: SM
authors.lastname: Nyenhuis
authors.affiliation: University of Illinois at Chicago, Chicago, Ill.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.affiliation: Illinois Institute of Technology Institute of Design, Chicago, Ill.
authors.forename: Kim
authors.initials: K
authors.lastname: Erwin
authors.affiliation: Rush University Health Center, Chicago, Ill.
authors.forename: Giselle
authors.initials: G
authors.lastname: Mosnaim
authors.affiliation: Sinai Health System, Chicago, Ill.
authors.forename: Helen
authors.initials: H
authors.lastname: Margellos-Anast
authors.affiliation: University of Chicago, Chicago, Ill.
authors.forename: S Margaret
authors.initials: SM
authors.lastname: Paik
authors.affiliation: Chicago Asthma Consortium, Chicago, Ill.
authors.forename: Stacy
authors.initials: S
authors.lastname: Ignoffo
authors.affiliation: Illinois Emergency Department Asthma Surveillance Project for the CHICAGO Plan Consortium, Chicago, Ill.
authors.forename: Michael
authors.initials: M
authors.lastname: McDermott
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D002648:Child; D004636:Emergency Service, Hospital; D055317:Evidence-Based Practice; D006801:Humans; D063868:Patient Outcome Assessment; D010360:Patient Transfer; D011320:Primary Health Care; D012648:Self Care; D014481:United States
keywords: Asthma; care coordination; care transitions; disparities; education; emergency department; patient-centered; pediatric