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Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT
Alexander G Fiks1, Stephanie L Mayne2, Dean J Karavite3
1The Pediatric Research Consortium, Center for Biomedical Informatics, PolicyLab, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Departments of Pediatrics, and fiks@email.chop.edu.
Insights
An electronic health record (EHR)-linked patient portal called MyAsthma improved shared decision-making for pediatric asthma care. This tool proved feasible and acceptable, leading to better asthma control and fewer missed workdays for parents.
Area of Science:
- Pediatric healthcare
- Digital health interventions
- Chronic disease management
Background:
- Electronic health record (EHR)-linked patient portals offer a novel method for enhancing shared decision-making between families of children with chronic conditions and their pediatricians.
- The MyAsthma portal was developed to specifically support shared decision-making in pediatric asthma care, addressing feasibility, acceptability, and impact.
Purpose of the Study:
- To evaluate the feasibility and acceptability of the MyAsthma portal among families of children with asthma.
- To assess the impact of the MyAsthma portal on child health care utilization, asthma control, and missed school/work days.
Main Methods:
- A 6-month randomized controlled trial was conducted across 3 primary care practices, comparing the MyAsthma portal with standard care.
- The MyAsthma portal tracks patient-reported concerns, goals, symptoms, medication adherence, and provides decision support.
- Outcomes were assessed using descriptive statistics and longitudinal regression models to compare differences between the intervention and control groups.
Main Results:
- Out of 60 enrolled families, 57% of parents in the intervention group actively used MyAsthma for at least 5 months.
- High satisfaction (92%) was reported, with parents noting improved communication, asthma management, and treatment awareness.
- Children in the intervention group experienced fewer asthma flares, and parents reported fewer missed workdays.
Conclusions:
- The EHR-linked MyAsthma portal demonstrated feasibility and acceptability for families managing pediatric asthma.
- Implementation of the MyAsthma portal led to clinically meaningful improvements in asthma outcomes and parental work productivity.
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.
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