Preference for and impact of telehealth vs in-person asthma visits among Black and Latinx adults.


Journal

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580

Informations de publication

Date de publication:
11 2023
Historique:
received: 20 03 2023
revised: 09 06 2023
accepted: 14 07 2023
medline: 6 11 2023
pubmed: 26 7 2023
entrez: 25 7 2023
Statut: ppublish

Résumé

Black and Latinx adults experience disproportionate asthma-related morbidity and limited specialty care access. The severe acute respiratory syndrome coronavirus 2 pandemic expanded telehealth use. To evaluate visit type (telehealth [TH] vs in-person [IP]) preferences and the impact of visit type on asthma outcomes among Black and Latinx adults with moderate-to-severe asthma. For this PREPARE trial ancillary study, visit type preference was surveyed by e-mail or telephone post-trial. Emergency medical record data on visit types and asthma outcomes were available for a subset (March 2020 to April 2021). Characteristics associated with visit type preferences, and relationships between visit type and asthma outcomes (control [Asthma Control Test] and asthma-related quality of life [Asthma Symptom Utility Index]), were tested using multivariable regression. A total of 866 participants consented to be surveyed, with 847 respondents. Among the participants with asthma care experience with both visit types, 42.0% preferred TH for regular checkups, which associated with employment (odds ratio [OR] = 1.61; 95% confidence interval [CI], 1.09-2.39; P = .02), lower asthma medication adherence (OR = 1.06; 95% CI, 1.01-1.11; P = .03), and having more historical emergency department and urgent care asthma visits (OR = 1.10 for each additional visit; 95% CI, 1.02-1.18; P = .02), after adjustment. Emergency medical record data were available for 98 participants (62 TH, 36 IP). Those with TH visits were more likely Latinx, from the Southwest, employed, using inhaled corticosteroid-only controller therapy, with lower body mass index, and lower self-reported asthma medication adherence vs those with IP visits only. Both groups had comparable Asthma Control Test (18.4 vs 18.9, P = .52) and Asthma Symptom Utility Index (0.79 vs 0.84, P = .16) scores after adjustment. TH may be similarly efficacious as and often preferred over IP among Black and Latinx adults with moderate-to-severe asthma, especially for regular checkups. ClinicalTrials.gov Identifier: NCT02995733.

Sections du résumé

BACKGROUND
Black and Latinx adults experience disproportionate asthma-related morbidity and limited specialty care access. The severe acute respiratory syndrome coronavirus 2 pandemic expanded telehealth use.
OBJECTIVE
To evaluate visit type (telehealth [TH] vs in-person [IP]) preferences and the impact of visit type on asthma outcomes among Black and Latinx adults with moderate-to-severe asthma.
METHODS
For this PREPARE trial ancillary study, visit type preference was surveyed by e-mail or telephone post-trial. Emergency medical record data on visit types and asthma outcomes were available for a subset (March 2020 to April 2021). Characteristics associated with visit type preferences, and relationships between visit type and asthma outcomes (control [Asthma Control Test] and asthma-related quality of life [Asthma Symptom Utility Index]), were tested using multivariable regression.
RESULTS
A total of 866 participants consented to be surveyed, with 847 respondents. Among the participants with asthma care experience with both visit types, 42.0% preferred TH for regular checkups, which associated with employment (odds ratio [OR] = 1.61; 95% confidence interval [CI], 1.09-2.39; P = .02), lower asthma medication adherence (OR = 1.06; 95% CI, 1.01-1.11; P = .03), and having more historical emergency department and urgent care asthma visits (OR = 1.10 for each additional visit; 95% CI, 1.02-1.18; P = .02), after adjustment. Emergency medical record data were available for 98 participants (62 TH, 36 IP). Those with TH visits were more likely Latinx, from the Southwest, employed, using inhaled corticosteroid-only controller therapy, with lower body mass index, and lower self-reported asthma medication adherence vs those with IP visits only. Both groups had comparable Asthma Control Test (18.4 vs 18.9, P = .52) and Asthma Symptom Utility Index (0.79 vs 0.84, P = .16) scores after adjustment.
CONCLUSION
TH may be similarly efficacious as and often preferred over IP among Black and Latinx adults with moderate-to-severe asthma, especially for regular checkups.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02995733.

Identifiants

pubmed: 37490981
pii: S1081-1206(23)00520-3
doi: 10.1016/j.anai.2023.07.012
pii:
doi:

Substances chimiques

Adrenal Cortex Hormones 0

Banques de données

ClinicalTrials.gov
['NCT02995733']

Types de publication

Clinical Trial Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

614-627.e2

Subventions

Organisme : NIAID NIH HHS
ID : K23 AI125785
Pays : United States

Informations de copyright

Copyright © 2023 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Israel C Ugalde (IC)

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida.

Amanda Ratigan (A)

DARTNet Institute, Aurora, Colorado.

Conner Merriman (C)

Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida.

Jing Cui (J)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Brianna Ericson (B)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Paula Busse (P)

Division of Allergy & Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Jennifer K Carroll (JK)

CU Anschutz Department of Family Medicine, University of Colorado, Aurora, Colorado; American Academy of Family Physicians National Research Network, Leawood, Kansas.

Thomas Casale (T)

Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida.

Juan Carlos Celedón (JC)

Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.

Tamera Coyne-Beasley (T)

Division of Adolescent Medicine, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, Alabama.

Maureen Fagan (M)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Anne L Fuhlbrigge (AL)

Department of Medicine, Pulmonary Science and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Gabriela Gaona Villarreal (GG)

DARTNet Institute, Aurora, Colorado.

Paulina Arias Hernandez (PA)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Sunit Jariwala (S)

Division of Allergy & Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.

Jean Kruse (J)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Nancy E Maher (NE)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Brian Manning (B)

American Academy of Family Physicians National Research Network, Leawood, Kansas.

Giselle Mosnaim (G)

Division of Allergy & Immunology, Department of Medicine, NorthShore University Health System, Evanston, Illinois.

Sylvette Nazario (S)

Division of Allergy and Immunology, Department of Internal Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Wilson D Pace (WD)

DARTNet Institute, Aurora, Colorado; American Academy of Family Physicians National Research Network, Leawood, Kansas.

Wanda Phipatanakul (W)

Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Victor Pinto-Plata (V)

Division of Pulmonary Critical Care, Department of Medicine, Lahey Hospital and Medical Center, Tufts University School of Medicine, Boston, Massachusetts.

Isaretta Riley (I)

Division of Pulmonary, Allergy & Critical Care Medicine, Duke University School of Medicine, Durham, North Carolina.

Jacqueline Rodriguez-Louis (J)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Justin Salciccioli (J)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Kartik Shenoy (K)

Department of Thoracic Medicine and Surgery, Temple University Health Systems, Lewis Katz School of Medicine, Philadelphia, Pennsylvania.

Joel B Shields (JB)

American Academy of Family Physicians National Research Network, Leawood, Kansas.

Yasir Tarabichi (Y)

Center for Clinical Informatics Research and Education, MetroHealth, Cleveland, Ohio.

Bonnie Telon Sosa (BT)

Division of Allergy and Immunology, Department of Internal Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Michael E Wechsler (ME)

Division of Pulmonology, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado.

Juan Wisnivesky (J)

Divisions of General Internal Medicine and Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Barbara Yawn (B)

Department of Family and Community Health, University of Minnesota, Minneapolis, Minnesota.

Elliot Israel (E)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts.

Juan Carlos Cardet (JC)

Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida. Electronic address: jcardet@usf.edu.

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