Improving Asthma Care within Vulnerable Populations THE CHILDREN S HOSPITAL OF PHILADELPHIA CHOP CENTER FOR OUTCOMES RESEARCH CHOP POLICY LAB MENTORS: DR. STEPHANIE DOUPNIK DR. CHEN KENYON --TEAM AIR--
Roadmap Asthma: Nationally and Locally Study 1: Mental Health & Hospital Risks Study 2: Adherence Feedback Intervention Analysis of Vulnerable Population
What is Asthma?
Diagnosis and Treatment of Asthma Asthma is chronic condition Rescue medication and Controller medication The Cost of Chronic Illness Asthma in perspective 6
Asthma: Nationally and Locally Nationally Pediatric Asthma Prevalence 1 Readmission Rates 2 Adherence 3 Socially and Medically Vulnerable Population Locally: Philadelphia, PA Prevalence 4 Readmission Rates Adherence 5 Socioeconomic Status Living Conditions Health Literacy
Aims of our Research Improving Mental Health Care Behavioral Cue Increasing Adherence to Medication Improving Asthma Care
Study 1 Identifying Risk Factors for Poor Hospital Outcomes in Pediatric Asthma Patients with Depression or Anxiety
Mental Health & Readmission Risk Significance of Co-morbid Conditions Mental Health and Hospital Outcomes 7-8 Children at CHOP w/ Clinically Significant Depression and/or Anxiety 30% Health Care and Societal Costs
Mental Health & Adherence Poor Asthma Control9-11 Mental Health is a driver for asthma adherence Asthma Hospital Risk Adherence
Study Design & Goals Study Design 2 Surveys Parent & Child Follow Up Doser Eligibility criteria Age Comorbidity Doser Goals: Coping with Hospital Stressors Improved disease management Future Applications
Study 2 Automated Adherence Feedback for High Risk Children with Asthma
Asthma Controller Medication Adherence Behavioral Cue Significance Cue Reward Objective Routine
Study Design & Goals
Demographic Data of Study Participants Marital Status Breakdown Education Level Breakdown Married Widowed Divorced Separated Never Married Living with a partner Prefer not to answer SC HS Some high school, but did not graduate High School graduate Some college or 2-year degree Four year college graduate
Successes and Complications Follow-up Calls Tech Literacy & Syncing Multiple Caregivers Similar trends in Study 1 Working with a Vulnerable Population
Preliminary Data Analysis: Adherence Survey 0.2.4.6.8 1 0 10 20 30 Days 1 18.7% Early 2 (24.8%) 3 43.7% 4 12.8% Non (18.7%) Moderate (43.7%) Sustained (12.8%)
Future Steps and Considerations Use of ClinCards: Monetary Incentive Asthma Control Type of Non- Adherence Aiding in Parental Responsibility Patient Preferences & Needs Other Considerations *Personalized Asthma Adherence Management*
Summary: Care for Chronic Conditions What I learned Primary Data Collection Study & Survey Design Use of Statistical Tools Working with Patients What our research informs Asthma Adherence Broader Scope of Chronic Conditions Asthma Adherence Hospital Risk
Q&A
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