Results Summary

What was the research about?

Asthma affects 1 in 10 children in the United States. When asthma isn’t managed well, children may need treatment in an emergency room, or ER. Doctors in the ER can use guidelines based on research to decide how to prepare families to manage asthma after they go home.

This study compared three ways to prepare children and caregivers to manage asthma after they leave the ER:

  • Guideline-based, ER only. In this approach, the children and caregivers received instructions in the ER about how to use their medicines and inhalers. Afterward, ER staff set up follow-up office visits.
  • Guideline-based, ER plus home visits. In addition to the meeting in the ER, children received up to five at-home visits from a community health worker who reviewed information and instructions from the ER meeting.
  • Enhanced usual care. Children received the care usually provided in the ER, plus education on how to use their inhalers. Children also received two free inhaler spacers. A spacer is a tube that holds the medicine in place so that it’s easier to breathe in.

What were the results?

The three ways of preparing families to manage asthma at home didn’t make a difference in how families said asthma affected their lives, such as whether children had trouble breathing or if caregivers could work. However, compared with children who received enhanced usual care, children who received guideline-based care in the ER—with or without home visits—were more likely to

  • Use medicine at home, including steroids, inhaler medicine, and rescue medicine
  • Schedule an office visit

Children who received at-home visits were more likely to fill prescriptions and go to the office visit than children who received guideline-based care in the ER only or enhanced usual care.

Who was in the study?

The study included 373 children ages 5 to 11 who received care at six hospitals in Chicago. Of these children, 64 percent were black, and 31 percent were Hispanic or Latino. The average age was 7, and 67 percent were boys. Eighty percent had public insurance.

What did the research team do?

The research team assigned children, by chance, to receive one of three types of care. During the ER visit and six months later, the team asked children and caregivers to fill out a survey about how asthma affected their lives. The team also looked at patients’ health and pharmacy records to find out how often

  • Children got an appointment for an office visit
  • Children went to the office visit
  • Children got prescriptions for asthma medicine before leaving the ER
  • Caregivers filled children’s prescriptions

Doctors, community health workers, public health officials, people with asthma, and caregivers of children with asthma helped plan the study.

What were the limits of the study?

The research team enrolled fewer children in the study than planned. In addition, only 63 percent of children completed the six-month study. Results may have been different if more children had enrolled in or completed the study.

Future research could look at how guideline-based meetings and the use of community health workers affect children and caregiver’s lives with more people in different locations.

How can people use the results?

Hospital staff and doctors can consider the results when planning ways to help children and caregivers manage asthma at home after going to the ER.

How this project fits under PCORI’s Research Priorities
PCORI identified asthma in African American and Hispanic/Latino populations as an important research topic. Patients, clinicians, and others wanted to learn how to encourage care that follows national asthma guidelines and improves patient-centered outcomes for African American and Hispanic/Latino populations. In 2013, PCORI launched an initiative on Treatment Options for African Americans and Hispanics/Latinos with Uncontrolled Asthma. The initiative funded this research project and others.

Final Research Report

View this project's final research report.

Stories and Videos

Media Mentions

Chicago Hospitals Form Partnership to Battle Asthma 'Hot Spots'
Chicago Sun-Times, May 9, 2018

This article describes this PCORI-funded study, which found that families of children who visited the emergency room for asthma and who received extra help were better able to manage prescriptions and subsequent doctor visits than those who didn’t receive additional support. “We work as a team, around the clock,” one caregiver involved in the program tells the newspaper. “Once we learned the triggers for each child’s asthma, we have been able to manage it more effectively. You have to be proactive.”

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

In general, the reviews were positive regarding the study’s conduct. Reviewer criticisms focused on seeking greater clarity and explanation in the text. In particular, reviewers asked for more detail on the interventions and how the researchers sought to maximize retention of project participants. The researchers revised the report to include additional description and discussion.

Conflict of Interest Disclosures

Project Information

Jerry A. Krishnan, MD, PhD
University of Illinois at Chicago
The Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Trial

Key Dates

December 2013
October 2018

Study Registration Information


Has Results
Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: May 24, 2023