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Peer training for parents reduced childhood asthma impairment, ED visits

A telephone-based, peer-training program for parents of children with persistent asthma reduced childhood asthma impairment and also significantly reduced ED visits and hospitalizations in children with Medicaid, according to recent study results.

Researchers studied 948 families with children aged 3 to 12 years with persistent asthma at 22 pediatric practices. The cluster-randomized trial included 462 families at 11 practices where parents received asthma management training by telephone from peer trainers (intervention) and 486 families who received usual care at the other 11 practices (control). Median duration of peer training was 3.8 hours per family, with a median of 18 calls. Interviews were conducted at 12 and 24 months to measure patient outcomes.

“In a planned subgroup analysis, we examined the heterogeneity of the intervention effect by insurance type (Medicaid vs. other),” the researchers wrote.

Families in the intervention cohort had 20.9 (95% CI, 9.1-32.7) additional symptom-free days per child compared with the control cohort, while ED visits did not differ between groups. Delayed intervention effect was indicated by reduced ED visits after 24 months (difference in mean visits per child, –0.28; 95% CI, –0.5 to –0.02).

Patients of parents who had 12 months of intervention showed 42% fewer ED visits (difference in mean visits per child, –0.5; 95% CI, –0.81 to –0.18) and 62% fewer hospitalizations, (difference in mean hospitalizations per child, –0.16; 95% CI, –0.3 to –0.014) in the Medicaid subgroup. At 24 months, reductions in health care use continued.

“Evidence from this large randomized trial suggests that a peer-training program delivered exclusively by telephone was effective in improving children’s asthma control and was popular with parents and physicians,” the researchers concluded. “We recommend this intervention be implemented for children with Medicaid insurance who have poorly controlled asthma.”

Disclosure: The researchers report research support from the National Heart, Lung, and Blood Institute.