Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.

TitleParent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
Publication TypeJournal Article
Year of Publication2015
AuthorsFiks AG, Mayne SL, Karavite DJ, Suh A, O'Hara R, A Localio R, Ross ME, Grundmeier RW
JournalPediatrics
Volume135
Issue4
Paginatione965-73
Date Published04/2015
ISSN1098-4275
KeywordsAbsenteeism, Adolescent, Anti-Asthmatic Agents, Asthma, Decision Making, Decision Support Techniques, Electronic Health Records, Feasibility Studies, Female, Hospitalization, Humans, Male, Medication Adherence, Parents, Primary Health Care, Professional-Family Relations, Prospective Studies, Treatment Outcome, United States
Abstract

BACKGROUND: Electronic health record (EHR)-linked patient portals are a promising approach to facilitate shared decision-making between families of children with chronic conditions and pediatricians. This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma.

METHODS: We conducted a 6-month randomized controlled trial of MyAsthma at 3 primary care practices. Families were randomized to MyAsthma, which tracks families' asthma treatment concerns and goals, children's asthma symptoms, medication side effects and adherence, and provides decision support, or to standard care. Outcomes included the feasibility and acceptability of MyAsthma for families, child health care utilization and asthma control, and the number of days of missed school (child) and work (parent). Descriptive statistics and longitudinal regression models assessed differences in outcomes between study arms.

RESULTS: We enrolled 60 families, 30 in each study arm (mean age 8.3 years); 57% of parents in the intervention group used MyAsthma during at least 5 of the 6 study months. Parents of children with moderate to severe persistent asthma used the portal more than others; 92% were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment. Parents in the intervention group reported that children had a lower frequency of asthma flares and intervention parents missed fewer days of work due to asthma.

CONCLUSIONS: Use of an EHR-linked asthma portal was feasible and acceptable to families and improved clinically meaningful outcomes.

DOI10.1542/peds.2014-3167
Alternate JournalPediatrics
PubMed ID25755233
PubMed Central IDPMC4379463
Grant List1P30HS021645 / HS / AHRQ HHS / United States
K23HD059919 / HD / NICHD NIH HHS / United States