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In pediatrics patients with Asthma (P), how does the use of telehealth services (I) compared to the use of virtual reality services (C) affect caregiver medication comprehension / compliance (O) Improved caregiver comprehension?

POPULATION / PROBLEM Asthma in school age children is the most frequent cause of health care use. Asthma is the most common chronic disease in children. Chronic asthma globally ranks the number of disability adjusted life years in children between the ages 5-14 years old, tops 10 causes. Children in low-income and middle-income countries have high levels of asthma symptoms. Interesting fact states asthma symptoms in children have been found in high income countries. Higher rates of children with asthma symptoms have been consistently found in children in low-income and middle-income countries.

The Primary cause of pediatric asthma is air pollutants and climate changes. Spearman correlation analysis was used to relate air pollutants and climate changes to pediatric asthma causes. Based on 8 years of environmental data and daily pediatric asthma visits to the hospital. Spearman analysis has proven air pollution, wind speed, and air quality index has a relation with pediatric asthma. Low income communities suffer the most being their air quality is not in the best condition. Caregivers in low income communities are not as knowledgeable about the chronic illness of asthma. Therefore, implementing telehealth to caregivers and children who suffer from chronic asthma would help in many positive ways.

INTERVENTIONS Telehealth for asthmatic, school-aged children (7-17 years old) from rural, underserved communities may reduce school and work absenteeism for both children and caregivers. The burden of traveling to and from appointments may be drastically reduced and may be cost efficient for the patient and caregiver especially in these low income environments. Adequate resources such as the internet, computer/ laptop, regular and/ or smartphones are necessary but may not always be readily available to get the needed care. Telehealth can be used in a variety of locations such as a home or school setting, as long as the necessary equipment is available.

The convenience of this type of healthcare can be used in almost any situation such as inclement weather, the patient or caregiver is too ill to travel or doesn't have the means such as money or transportation. Proper healthcare isn't always accessible to this population as opposed to an upper-class population. Without the necessary funding this population won't be able to receive and/ or provide adequate patient care. This population is vulnerable and they can benefit greatly from telehealth.

COMPARISON Although in-person visits with providers do have its benefits, such as physical assessment of patients' asthma, Telehealth provides a more convenient way for patients and caregivers who are not able to physically attend. Telehealth provides caregivers access to be able to speak with providers with questions they may have. As opposed to telehealth, in-person requires to be present and may not be able to be given fully all information when it comes to asthma. Also, telehealth has proven to be more successful with patients and caregivers in attendance, as opposed to in-person, where patients may not be able to attend.

However, in a recent study, implementing both in-person and telemedicine with patients and caregivers provide better access to care. Having telemedicine in schools is also beneficial in asthma control and assessment between providers, school and caregivers.

OUTCOMES

Concerning pediatric patients with asthma, the implementation of virtual platforms improved client-caregiver knowledge and understanding.

Participants acknowledged that with the virtual platform, their knowledge of asthma triggers and medication administration improved. In this study, the virtual adaptation of asthma education was just as successful as in-person instruction in self-management with asthma and increasing comprehension and self-reliance. One hundred percent of participants agreed that their confidence in managing their children's asthma, care adaptation, and emergency intervention had increased.

The incorporation of telehealth has improved caregiver comprehension through the accessibility of information and knowledge in the home setting.

The flexibility of telehealth can additionally offer information for preventative measures and precise health interventions. By having an enhanced patient-caregiver experience, providers can facilitate improvement in efficiency and time management of encounters with asthma education.

CONCLUSION

Asthma has a negative impact on the health of school aged children. In the United States alone, 10% of school aged children are plagued with Asthma; the risk increases when factors such as low socioeconomic status and race are considered.

Caretakers are tasked with the responsibility albeit at times overwhelming, of managing a serious illness with oftentimes sparse resources. Caregivers are essential to bring about desirable outcomes for the school aged child with asthma. School Based programs supplies resources to school aged children and their caretakers; bridging gaps in healthcare by providing access to care that is accessible to often underserved communities.

If executed properly, an Asthma Action Plan can reduce exacerbations exponentially; however, this requires that caretakers take on a proactive approach.

Telehealth services improves health outcomes of the school aged child; with care of the school aged child, being performed by caregivers, it is essential to promote healthy behaviors. Caregiver comprehension will result in a decline in asthma exacerbations, which in turn improve caregiver satisfaction, leading to further adaptation of health behaviors, subsequently creating a cyclic development of healthy behaviors.