A self-management intervention helps older adults decrease asthma exacerbations and have better asthma control, according to findings presented at the American Academy of Allergy, Asthma and Immunology annual meeting.
“Older adults are just as likely to have asthma as other age groups, and unfortunately have the highest asthma mortality rate as well as very high asthma-related hospitalization and ED rates,” Alan P. Baptist, MD, MPH, from the division of allergy and clinical immunology at the University of Michigan, told Healio Internal Medicine. “The preferences, challenges and barriers to care of older adults may be different than those of younger populations.”
Baptist and colleagues conducted a blinded, randomized controlled trial to determine if a self-management asthma intervention could improve asthma exacerbations in older adults. Asthma exacerbations were defined as unscheduled office, ED or hospital visits related to asthma. The researchers enrolled 189 patients aged 55 years or older with persistent asthma.
Participants attended group sessions and received individual telephone calls on the intervention which included a combination of standard asthma management and identification of goals, barriers and strategies to overcome barriers, according to Baptist. Those in the control group received standard asthma education only, he said.
At 3, 6, and 12 months, the researchers assessed asthma exacerbations, spirometric values, FeNO, asthma control, asthma quality of life and asthma self-management. They randomized 172 participants who received at least one treatment dose and 145 of whom were evaluated at 1 year.
Results showed that participants in the intervention group had a lower likelihood of experiencing an asthma exacerbation (26.9% vs. 47.2%), compared with those in the control group. A lower asthma exacerbation rate (0.8% vs. 1.9%), better asthma control (19.9% vs. 18.6%) and higher asthma self-management scores (8.9% vs. 8.4%) was also observed in the intervention group.
After controlling for potential confounding factors, statistically significant decreases in asthma exacerbations and asthma exacerbation rate remained. However, improvements in asthma control and self-management did not remain significant.
“A six-session self-management intervention can successfully decrease asthma exacerbations among older adults,” Baptist and colleagues wrote. – by Alaina Tedesco
Baptist AP, et al. “A self-regulation intervention can decrease asthma exacerbations among older adults.” Presented at: American Academy of Allergy, Asthma and Immunology annual meeting; March 2-5, 2018; Orlando.
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