A Randomized Controlled Trial of an Interactive Voice Response Telephone System and Specialist Nurse Support for Childhood Asthma Management

Xu, Chunsheng; Jackson, Mary; Scuffham, Paul Anthony; Wootton, Richard; Simpson, Pamela; Whitty, Jennifer A.; Wolfe, Rory; Wainwright, Claire

doi:10.3109/02770903.2010.493966

Cited by 28 publications

(41 citation statements)

References 14 publications

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“…These same arguments can be extended to automated telephone interventions such as CareCall as a supplemental method to traditional rehabilitation, especially given the evidence that users do indeed form relationships with the IVR system as they would with a 'live' person. 8 A major strength of automated interventions similar to CareCall is their potential for substantial health-care cost-savings, 22 given that most traditional telephone follow up occurs at specialty medical facilities requiring dedicated staff and resources. Importantly, Xu et al 22 demonstrates savings may be achieved with little loss in efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…8 A major strength of automated interventions similar to CareCall is their potential for substantial health-care cost-savings, 22 given that most traditional telephone follow up occurs at specialty medical facilities requiring dedicated staff and resources. Importantly, Xu et al 22 demonstrates savings may be achieved with little loss in efficacy. A further strength over traditional telephone follow up is CareCall's ability to identify unmet needs even many years post diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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A pilot study of a telehealth intervention for persons with spinal cord dysfunction

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A pilot study of a telehealth intervention for persons with spinal cord dysfunction

et al. 2013

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“…IVRs have demonstrated some efficacy in chronic disease management, including screening, preventive services, and medication adherence [15][16][17]. IVR can obtain information from patients, deliver tailored instructions, and allow for remote monitoring [18]. Previous studies of IVR interventions have used quasi-experimental designs [19,20] and clinical trials [16,21] but have had mixed results; very little rigorous work has been done to evaluate IVR interventions focused on care transitions; thus a rigorous, real-world study of an IVR-based intervention to support care transitions in congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) was needed.…”

Section: Introductionmentioning

confidence: 99%

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Ritchie

Houston

Richman

et al. 2016

Behav. Med. Pract. Policy Res.

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Care transitions from the hospital to home remain a vulnerable time for many patients, especially for those with heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Despite regular use in chronic disease management, it remains unclear how technology can best support patients during their transition from the hospital. We sought to evaluate the impact of a technology-supported care transition support program on hospitalizations, days out of the community and mortality. Using a pragmatic randomized trial, we enrolled patients (511 enrolled, 478 analyzed) hospitalized with CHF/COPD to "E-Coach," an intervention with conditionspecific customization and in-hospital and postdischarge support by a care transition nurse (CTN), interactive voice response post-discharge calls, and CTN follow-up versus usual post-discharge care (UC). The primary outcome was 30-day rehospitalization. Secondary outcomes included (1) rehospitalization and death and (2) days in the hospital and out of the community. ECoach and UC groups were similar at baseline except for gender imbalance (p = 0.02). After adjustment for gender, our primary outcome, 30-day rehospitalization rates did not differ between the E-Coach and UC groups (15.0 vs. 16.3 %, adjusted hazard ratio [95 % confidence interval]: 0.94 [0.60, 1.49]). However, in the COPD subgroup, ECoach was associated with significantly fewer days in the hospital (0.5 vs.

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“…It is difficult to deduce which type of intervention is the most effective, because none yielded consistent results. Except for 3 studies that found no significant differences between their comparators8,74,76, findings from other studies showed that these interventions benefited all severity levels of asthma (from mild to potentially fatal asthma).…”

Section: Background Of Reviewed Studiesmentioning

confidence: 95%

“…The majority of the studies originated from the United States of America7,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54, followed by Europe8,55,56,57,58,59,60,61,62,63,64,65,66,67, Asia68-72, and Australia 73,7475,76. There was one economic evaluation concerning enhanced asthma management30 done in 1991, and at least one between 1994 and 2012.…”

Section: Background Of Reviewed Studiesmentioning

confidence: 99%

Economic Evaluation of Enhanced Asthma Management: A Systematic Review

Yong

Shafie

2013

Value in Health

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Objectives:To evaluate and compare full economic evaluation studies on the cost-effectiveness of enhanced asthma management (either as an adjunct to usual care or alone) vs. usual care alone.Methods:Online databases were searched for published journal articles in English language from year 1990 to 2012, using the search terms ‘“asthma” AND (“intervene” OR “manage”) AND (“pharmacoeconomics” OR “economic evaluation” OR “cost effectiveness” OR “cost benefit” OR “cost utility”)’. Hand search was done for local publishing. Only studies with full economic evaluation on enhanced management were included (cost consequences (CC), cost effectiveness (CE), cost benefit (CB), or cost utility (CU) analysis). Data were extracted and assessed for the quality of its economic evaluation design and evidence sources.Results:A total of 49 studies were included. There were 3 types of intervention for enhanced asthma management: education, environmental control, and self-management. The most cost-effective enhanced management was a mixture of education and self-management by an integrated team of healthcare and allied healthcare professionals. In general, the studies had a fair quality of economic evaluation with a mean QHES score of 73.7 (SD=9.7), and had good quality of evidence sources.Conclusion:Despite the overall fair quality of economic evaluations but good quality of evidence sources for all data components, this review showed that the delivered enhanced asthma managements, whether as single or mixed modes, were overall effective and cost-reducing. Whilst the availability and accessibility are an equally important factor to consider, the sustainability of the cost-effective management has to be further investigated using a longer time horizon especially for chronic diseases such as asthma.

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A Randomized Controlled Trial of an Interactive Voice Response Telephone System and Specialist Nurse Support for Childhood Asthma Management

Abstract: This study suggested that both IVR and Nurse Support interventions may be cost-saving from a health system perspective, with IVR providing the greatest benefit and this pilot study provides a strong basis for developing larger trials with longer follow-up.

Cited by 28 publications

References 14 publications

A pilot study of a telehealth intervention for persons with spinal cord dysfunction

A pilot study of a telehealth intervention for persons with spinal cord dysfunction

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Economic Evaluation of Enhanced Asthma Management: A Systematic Review

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