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The following is a summary of “Effect of the Telemedicine Enhanced Asthma Management Through the Emergency Department (TEAM-ED) Program on Asthma Morbidity: A Randomized Controlled Trial,” published in the March 2024 issue of Journal of Pediatrics by Halterman et al. 

Researchers conducted a retrospective study to evaluate the effectiveness of a telemedicine-based program in reducing asthma morbidity among children visiting the emergency department (ED) for asthma by enhancing primary care follow-up and promoting guideline-based care.  

They enrolled children (3-12 years) with persistent asthma who visited the ED for asthma and randomly assigned them to either Telemedicine Enhanced Asthma Management through the Emergency Department (TEAM-ED) or enhanced usual care (eUC). The TEAM-ED included school-based telemedicine follow-ups conducted by a primary care provider (PCP), point-of-care prompts to ensure guideline-based care, and up to 2 additional telemedicine follow-ups. The primary outcome was the mean number of symptom-free days (SFDs) over 2 weeks, assessed at 3, 6, 9, and 12 months.  

The results showed that 373 children were included from 2016 to 2021 (participation rate 68%), with a mean age of 6.4 years, 54% identified as Black, 32% as Hispanic, and 77% covered by public insurance. Baseline asthma severity and demographic characteristics were similar between groups. Among those in the TEAM-ED group, 91% had at least 1 telemedicine visit, and 41% completed 3 visits. At 3 months, caregivers of children in TEAM-ED reported higher follow-up visit rates (66% vs 48%; aOR, 2.07; 95% CI, 1.28-3.33), more preventive asthma medication actions (90% vs 79%; aOR, 3.28; 95% CI, 1.56-6.89), and greater use of preventive medication (82% vs 69%; aOR, 2.716; 95% CI, 1.45-5.08) compared to eUC. No differences were observed in medication adherence or asthma morbidity. Prepandemic data analysis indicated greater improvement in SFDs over time in TEAM-ED compared to eUC.  

Investigators concluded that the TEAM-ED intervention improved follow-up and preventive care post-asthma-related ED visits, but additional ongoing management support was needed to enhance morbidity and adherence outcomes. 

Source: jpeds.com/article/S0022-3476(23)00731-X/abstract