Asthma Care from Home: Study protocol for an effectiveness-implementation evaluation of a virtually enabled asthma care initiative in children in rural NSW.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 02 01 2024
accepted: 16 05 2024
medline: 13 6 2024
pubmed: 13 6 2024
entrez: 13 6 2024
Statut: epublish

Résumé

Asthma is the leading source of unscheduled hospitalisation in Australian children, with a high burden placed upon children, their parents/families, and the healthcare system. In Australia, there are widening disparities in paediatric asthma care including inequitable access to comprehensive ongoing and planned asthma care for children. The Asthma Care from Home Project is a comprehensive virtually enabled asthma model of care that aims to a. supports families, communities and healthcare providers, b. flexible and locally acceptable, and c. allow for adoption of innovations such as digital technologies so that asthma care can be provided "from home", reduce potentially preventable asthma hospitalisation, and ensure satisfaction at a patient, family, and healthcare provider level. The model of care includes standardisation of discharge care through provision of an asthma discharge resource pack containing individual asthma action plan, follow-up letters for the child's general practitioner (GP) and school/child care, and access to online asthma educational sessions and resource; post-discharge care coordination through text message reminders for families for regular GP review, email correspondence with their child's GP and school/childcare; and virtual home visits to discuss home environmental triggers, provide personalised asthma education and respond to parental concerns relating to their child's asthma. This study is comprised of three components: 1) a quasi-experimental pre/post impact evaluation assessing the impact of the model on healthcare utilisation and asthma control measures; 2) a mixed-methods implementation evaluation to understand how and why our intervention was effective or ineffective in producing systems change; 3) an economic evaluation to assess the cost-effectiveness of the proposed model of care from a family and health services perspective. This study aims to improve access to asthma care for children in rural and remote areas. Implementation evaluation and economic evaluation will provide insights into the sustainability and scalability of the asthma model of care.

Sections du résumé

BACKGROUND BACKGROUND
Asthma is the leading source of unscheduled hospitalisation in Australian children, with a high burden placed upon children, their parents/families, and the healthcare system. In Australia, there are widening disparities in paediatric asthma care including inequitable access to comprehensive ongoing and planned asthma care for children.
METHODS METHODS
The Asthma Care from Home Project is a comprehensive virtually enabled asthma model of care that aims to a. supports families, communities and healthcare providers, b. flexible and locally acceptable, and c. allow for adoption of innovations such as digital technologies so that asthma care can be provided "from home", reduce potentially preventable asthma hospitalisation, and ensure satisfaction at a patient, family, and healthcare provider level. The model of care includes standardisation of discharge care through provision of an asthma discharge resource pack containing individual asthma action plan, follow-up letters for the child's general practitioner (GP) and school/child care, and access to online asthma educational sessions and resource; post-discharge care coordination through text message reminders for families for regular GP review, email correspondence with their child's GP and school/childcare; and virtual home visits to discuss home environmental triggers, provide personalised asthma education and respond to parental concerns relating to their child's asthma. This study is comprised of three components: 1) a quasi-experimental pre/post impact evaluation assessing the impact of the model on healthcare utilisation and asthma control measures; 2) a mixed-methods implementation evaluation to understand how and why our intervention was effective or ineffective in producing systems change; 3) an economic evaluation to assess the cost-effectiveness of the proposed model of care from a family and health services perspective.
DISCUSSION CONCLUSIONS
This study aims to improve access to asthma care for children in rural and remote areas. Implementation evaluation and economic evaluation will provide insights into the sustainability and scalability of the asthma model of care.

Identifiants

pubmed: 38870226
doi: 10.1371/journal.pone.0304711
pii: PONE-D-23-36574
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0304711

Informations de copyright

Copyright: © 2024 Mackle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Ryan Mackle (R)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Respiratory Department, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

Carmen Crespo Gonzalez (C)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

Mei Chan (M)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

Michael Hodgins (M)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

Nan Hu (N)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

Blake Angell (B)

The George Institute for Global Health, UNSW Sydney, NSW, Sydney, Australia.

Louisa Owens (L)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Respiratory Department, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

Jeffery Fletcher (J)

Department of Paediatrics, The Tweed Hospital, Northern NSW Local Health District, Tweed Heads, Australia.
School of Medicine, Griffth University, Gold Coast, QLD, Australia.

Timothy McCrossin (T)

Department of Paediatrics, Bathurst Base Hospital, Western NSW Local Health District, Bathurst, NSW, Australia.
Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, NSW, Australia.

Susie Piper (S)

Department of Paediatrics, South East Regional Hospital, Southern NSW Local Health District, Bega, NSW, Australia.

Aunty Kerrie Doyle (AK)

Discipline of Indigenous Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia.

Sue Woolfenden (S)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Department of Community Paediatrics, Sydney Local Health District, Sydney, NSW, Australia.

Bronwyn Gould (B)

General Practice, Paddington, NSW, Australia.

Flic Ward (F)

Parent of Child with Asthma, Australia.

Raghu Lingam (R)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Department of Community Paediatrics, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

Adam Jaffe (A)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Respiratory Department, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

Melinda Gray (M)

Respiratory Department, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

Nusrat Homaira (N)

Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Respiratory Department, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Sydney, NSW, Australia.

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Classifications MeSH