Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness

Hall, Kerry; Petsky, Helen; Chang, Anne B.; O'Grady, Kerry‐Ann F

doi:10.1002/14651858.cd012315.pub2

Cited by 9 publications

(19 citation statements)

References 55 publications

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“…First, we need to improve current strategies to optimize asthma control and improve asthma‐related QoL, with the ultimate aim to prevent future (PICU) admissions in asthmatic children. Evidence suggests that improving physician access after hospital admission, with individual discharge plans, is beneficial in preventing hospital readmissions 38,39 . Future studies should focus on identifying children at risk for severe asthma symptoms and hospital admission to provide targeted follow‐up and management to prevent hospital admission and morbidity.…”

Section: Discussionmentioning

confidence: 99%

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Boeschoten

Dulfer

Boehmer

et al. 2020

Pediatric Pulmonology

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Objectives: To prospectively evaluate quality of life (QoL) and psychosocial outcomes in children with severe acute asthma (SAA) after pediatric intensive care (PICU) admission compared to children with SAA who were admitted to a general ward (GW). In addition, we assessed posttraumatic stress (PTS) and asthma-related QoL in the parents. Methods: A preplanned follow-up of 3 to 9 months of our nationwide prospective multicenter study, in which children with SAA admitted to a Dutch PICU (n = 110) or GW (n = 111) were enrolled between 2016 and 2018. Asthma-related QoL, PTS symptoms, emotional and behavioral problems, and social impact in children and/or parents were assessed with validated web-based questionnaires. Results: We included 100 children after PICU and 103 after GW admission, with a response rate of 50% for the questionnaires. Median time to follow-up was 5 months (range: 1-12 months). Time to reach full schooldays after admission was significantly longer in the PICU group (mean of 10 vs 4 days, P = .001). Parents in the PICU group reported more PTS symptoms (intrusion P = .01, avoidance P = .01, arousal P = .02) compared to the GW group. Conclusion: No significant differences were found between PICU and GW children on self-reported outcome domains, except for the time to reach full schooldays. PICU parents reported PTS symptoms more often than the GW group. Therefore, monitoring asthma symptoms and psychosocial screening of children and parents after PICU admission should both be part of standard care after SAA. This should identify those who are at risk for developing PTSD, to timely provide appropriate interventions.

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Section: Discussionmentioning

confidence: 99%

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Boeschoten

Dulfer

Boehmer

et al. 2020

Pediatric Pulmonology

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“…Chronic bronchiectasis and primary antibody deficiency are burdensome diseases for patients and their families, and research into psychosocial interventions for these patients is needed. Expansion of multi-disciplinary care for patients with primary antibody deficiency-associated bronchiectasis (i.e., building teams of immunologists, pulmonologists, nurses, mental health professionals, case-workers, and respiratory and physical therapists), is critical to ensuring that health outcomes for these patients meet or exceed those for patients with bronchiectasis secondary to other etiologies (117)(118)(119) (Figure 5).…”

Section: Future Directions In Bronchiectasis Managementmentioning

confidence: 99%

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

2020

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Bronchiectasis, the presence of bronchial wall thickening with airway dilatation, is a particularly challenging complication of primary antibody deficiencies. While susceptibility to infections may be the primary factor leading to the development of bronchiectasis in these patients, the condition may develop in the absence of known infections. Once bronchiectasis is present, the lungs are subject to a progressive cycle involving both infectious and non-infectious factors. If bronchiectasis is not identified or not managed appropriately, the cycle proceeds unchecked and yields advanced and permanent lung damage. Severe symptoms may limit exercise tolerance, require frequent hospitalizations, profoundly impair quality of life (QOL), and lead to early death. This review article focuses on the appropriate identification and management of bronchiectasis in patients with primary antibody deficiencies. The underlying immune deficiency and the bronchiectasis need to be treated from combined immunology and pulmonary perspectives, reflected in this review by experts from both fields. An aggressive multidisciplinary approach may reduce exacerbations and slow the progression of permanent lung damage.

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“…The second article was a Cochrane Systematic review examined the use of caseworker compared to non-caseworker assigned discharge plans for children with chronic respiratory illnesses (i.e., asthma, bronchiectasis) to reduce hospital readmissions (21). We excluded this review as none of the four studies involved children with bronchiectasis.…”

Section: Resultsmentioning

confidence: 99%

Perspective: Using Bronchiectasis Action Management Plans for Children With Bronchiectasis—Can It Improve Clinical Care?

et al. 2019

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While once thought to be rare, bronchiectasis has been increasing globally over the last 15 years. Bronchiectasis is a major contributor to chronic lung morbidity and mortality but remains a neglected disease in respiratory health globally. Currently, few high-level evidence-based management strategies are available for children with bronchiectasis. Strategies to improve clinical outcomes associated with exacerbations are important. In other respiratory conditions such as asthma and chronic obstructive pulmonary disease, use of personalized written management plans have been shown to improve clinical outcomes. Personalized management plans have also been recommended as part of treatment plans in adults with bronchiectasis. We thus undertook a review of the current literature to determine available evidence, and to establish whether a personalized written bronchiectasis action management plan (BAMP) improves clinical outcomes in children with bronchiectasis. Our search identified 43 articles; 16 duplicates were removed and a further 23 were excluded on titles and abstracts alone. Four full-text articles were reviewed but excluded. In the absence of any published studies, it remains unknown whether the use of BAMP is beneficial for improving clinical outcomes for children with bronchiectasis. These results have highlighted this clinical gap and identified the need for high-quality research to inform practice. Until high-quality evidence is available, clinicians are advised to adhere to current national and/or international guidelines.

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Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness

Abstract: Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness.

Cited by 9 publications

References 55 publications

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

Perspective: Using Bronchiectasis Action Management Plans for Children With Bronchiectasis—Can It Improve Clinical Care?

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