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    ABSTRACT: The study was conducted to test the feasibility of a telephone-based self-management program for adults with epilepsy. The program was based on social cognitive theory and principles of motivational interviewing (MI). Twenty-two adults with epilepsy were recruited from hospital-based epilepsy clinics. The mean age of participants was 43 years, and 68% were men. Participants were randomly assigned to the intervention or control group. Those in the intervention group received a five-session intervention with a nurse trained in MI counseling. Following an in-person introductory session, the remaining four sessions were conducted by phone. Ninety-five percent of the 55 planned MI sessions and the 44 planned courtesy calls for those in the control group were completed, demonstrating high acceptance of the program. Participants were very satisfied with the program and noted the benefits of the telephone delivery method. Analysis of outcomes provided support for continued development and testing of the program.
    Epilepsy & Behavior 12/2008; 14(1):232-6. · 1.84 Impact Factor
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    ABSTRACT: Improper inhaler technique is a common problem affecting asthma control and healthcare costs. Telephonic asthma management can increase access to care while reducing costs and hospitalizations. However, no reliable method has been established for telephonically evaluating and correcting inhaler technique. The purpose of this study was to pilot test a method for assessing and correcting patient inhaler technique via telephone. Participants (n=30) were adults with asthma using metered-dose inhalers (MDIs) and diskus inhalers. A pharmacist was located in one room and communicated via telephone with a participant in another room. The pharmacist telephonically assessed and taught inhaler technique. Participants were video-recorded, and videos were later examined by a second pharmacist to visually evaluate inhaler technique. Participants were assigned pre- and posteducation inhaler technique scores for the telephonic and video assessments. Scores were based on summated scales for MDI (0-9) and diskus (0-11) inhalers. Paired samples t-tests were used to compare telephone and video assessments. Findings indicated a significant difference between the telephone and video assessments of MDI technique (p<0.05); however, no difference was found for the diskus inhaler. Comparing pre- and posteducation inhaler technique for MDI and diskus, mean scores significantly improved from 5.7 to 7.8 (p<0.05) and from 8.5 to 10.4 (p<0.05), respectively. The telephonic method was able to improve and detect some deficiencies in patients' inhaler technique. However, modifications and further investigation will more clearly determine the role and value of such a telephonic intervention.
    Telemedicine and e-Health 09/2011; 17(9):734-40. · 1.40 Impact Factor
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    ABSTRACT: Current guidelines recommend that all children obtain follow-up within 1 to 4 weeks after an emergency department (ED) visit for acute asthma. Follow-up may be an important link to reestablish regular care with the primary care provider, review reasons for the ED visit, and update the home management plan. Obtaining follow-up from the ED can be challenging. Studies have reported baseline follow-up rates between 7% and 44% without intervention. Successful interventions report follow-up rates of 36% to 78%. Studies that demonstrated improved follow-up from the ED found methods to personalize care such as individualized education, assistance with follow-up, and/or providing medications or transportation free of charge. A few studies effectively used computer-based interventions in the ED. As electronic systems become more common in the ED, integrating asthma care, personalized education, and scheduling follow-up in real time may be possible.
    Clinical Pediatric Emergency Medicine 01/2009; 10(2):109-114.

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