Preference for and impact of telehealth vs in-person asthma visits among Black and Latinx adults

Israel C. Ugalde, Amanda Ratigan, Conner Merriman, Jing Cui, Brianna Ericson, Paula Busse, Jennifer K. Carroll, Thomas Casale, Juan Carlos Celedón, Tamera Coyne-Beasley, Maureen Fagan, Anne L. Fuhlbrigge, Gabriela Gaona Villarreal, Paulina Arias Hernandez, Sunit Jariwala, Jean Kruse, Nancy E. Maher, Brian Manning, Giselle Mosnaim, Sylvette NazarioWilson D. Pace, Wanda Phipatanakul, Victor Pinto-Plata, Isaretta Riley, Jacqueline Rodriguez-Louis, Justin Salciccioli, Kartik Shenoy, Joel B. Shields, Yasir Tarabichi, Bonnie Telon Sosa, Michael E. Wechsler, Juan Wisnivesky, Barbara Yawn, Elliot Israel, Juan Carlos Cardet

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Black and Latinx adults experience disproportionate asthma-related morbidity and limited specialty care access. The severe acute respiratory syndrome coronavirus 2 pandemic expanded telehealth use. Objective: To evaluate visit type (telehealth [TH] vs in-person [IP]) preferences and the impact of visit type on asthma outcomes among Black and Latinx adults with moderate-to-severe asthma. Methods: For this PREPARE trial ancillary study, visit type preference was surveyed by e-mail or telephone post-trial. Emergency medical record data on visit types and asthma outcomes were available for a subset (March 2020 to April 2021). Characteristics associated with visit type preferences, and relationships between visit type and asthma outcomes (control [Asthma Control Test] and asthma-related quality of life [Asthma Symptom Utility Index]), were tested using multivariable regression. Results: A total of 866 participants consented to be surveyed, with 847 respondents. Among the participants with asthma care experience with both visit types, 42.0% preferred TH for regular checkups, which associated with employment (odds ratio [OR] = 1.61; 95% confidence interval [CI], 1.09-2.39; P =.02), lower asthma medication adherence (OR = 1.06; 95% CI, 1.01-1.11; P =.03), and having more historical emergency department and urgent care asthma visits (OR = 1.10 for each additional visit; 95% CI, 1.02-1.18; P =.02), after adjustment. Emergency medical record data were available for 98 participants (62 TH, 36 IP). Those with TH visits were more likely Latinx, from the Southwest, employed, using inhaled corticosteroid–only controller therapy, with lower body mass index, and lower self-reported asthma medication adherence vs those with IP visits only. Both groups had comparable Asthma Control Test (18.4 vs 18.9, P =.52) and Asthma Symptom Utility Index (0.79 vs 0.84, P =.16) scores after adjustment. Conclusion: TH may be similarly efficacious as and often preferred over IP among Black and Latinx adults with moderate-to-severe asthma, especially for regular checkups. Trial Registration: ClinicalTrials.gov Identifier: NCT02995733.

Original languageEnglish
Pages (from-to)614-627.e2
JournalAnnals of Allergy, Asthma and Immunology
Volume131
Issue number5
DOIs
StatePublished - Nov 2023
Externally publishedYes

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