FLOURISH: A Randomized Controlled Trial Comparing the Effects of Post-Discharge Phone Calls for Pediatric Patients on Parental Asthma Self-Efficacy, Return ED Visits, and Follow-Up Visit Attendance

Purpose: The purpose of this randomized controlled trial was to evaluate the impact of a post-hospitalization phone call on the self-administered parent asthma management self-efficacy (PAMSE) scale, attendance at post-hospitalization follow-up appointments, and re-presentation to the admitting hospital.
Background/significance: Transitioning from the hospital to home is vulnerable time for patients and caregivers as they are under stress which can hinder their ability to comprehend discharge instructions and, ultimately, their adherence to the discharge plan once home. Post-discharge phone calls are an intervention aimed at decreasing preventable readmissions by allowing providers to address any care gaps and reinforce discharge instructions in the period after discharge. Asthma is the most common chronic disease in pediatrics, affecting about 8.3% of children in the United States. Many adult care transition programs exist, but there is a paucity of literature to support implementation of follow-up phone calls and subsequent effect on positive outcomes in the pediatric asthma population.
Methods: The parents of 174 patients (86 in the intervention group and 88 in the control group) aged 2 years and older admitted to the hospital with status asthmaticus were enrolled. All patients received standard discharge education. The intervention group also received a 48–72-hour post-hospitalization phone call evaluating patient status, reinforcing asthma education and follow-up appointment(s). A PAMSE score was evaluated at discharge and 2 weeks post-discharge. Alpha significance level was set to 10% to identify relationships within the instrument analysis.
Results: Both groups demonstrated a statistically significant change in PAMSE scale total score post-discharge (N=174). However, the intervention group demonstrated improved PAMSE scores specific to confidence in their children taking medication (p = 0.029) and helping their child stay calm during a serious breathing problem (p