Telephone coaching for parents of children with asthma: impact and lessons learned.

ABSTRACT

OBJECTIVE: To determine whether an asthma coaching program can improve parent and child asthma-related quality of life (QOL) and reduce urgent care events. DESIGN: Randomized controlled trial of usual care vs usual care with coaching. Comparisons were made between groups using mixed models. SETTING: A Midwest city. PARTICIPANTS: A community-based sample of 362 families with a child aged 5 to 12 years with persistent asthma. INTERVENTION A 12-month structured telephone coaching program in which trained coaches provided education and support to parents for 4 key asthma management behaviors. MAIN OUTCOME MEASURES: Parental and child QOL measured with a validated, interview-administered, 7-point instrument and urgent care events in a year (unscheduled office visits, after-hours calls, emergency department visits, or hospitalizations) determined by record audit. RESULTS: Parental asthma-related QOL scores improved by an average of 0.67 units (95% confidence interval [CI], 0.49 to 0.84) in the intervention group and 0.28 units (95% CI, 0.10 to 0.46) in the control group. The difference between study groups was statistically significant (difference, 0.38; 95% CI, 0.14 to 0.63). No between-group difference was found in the change in the child's QOL (difference, -0.17; 95% CI, -0.47 to 0.12) or in the mean number of urgent care events per year (difference, 1.15; 95% CI, 0.82 to 1.61). The proportion of children with very poorly controlled asthma in the intervention group decreased compared with the control group (difference, 0.34; 95% CI, 0.21 to 0.48). CONCLUSIONS: A telephone coaching program can improve parental QOL and can be implemented without additional physician training or practice redesign.