Asthma Intervention Improves Exacerbation Outcomes for Older Adults

Older adults with asthma have higher rates of morbidity and mortality compared with younger patients. Researchers evaluated a self-management asthma intervention as a way to decrease asthma exacerbations in older adults. Alan P. Baptist, MD, MPH, FAAAAI, of the Division of Allergy and Clinical Immunology at the University of Michigan in Ann Arbor, and colleagues found that this intervention can successfully decrease asthma exacerbations in this patient population. The results were presented at the 2018 AAAAI Annual Meeting.

They enrolled 189 adults ≥55 years old with persistent asthma. The blinded, randomized, controlled trial included a six-session asthma self-management intervention, which was conducted via group sessions and individual telephone calls. Outcomes were assessed at three, six, and 12 months and included:

• Asthma exacerbations (defined as unscheduled office visits, emergency department visits, or hospitalizations for asthma)
• Spirometric values
• Fractional exhaled nitric oxide
• Asthma control
• Asthma quality of life
• Asthma self-management

A total of 172 patients were randomized and received at least one treatment dose, and 145 (84%) were available for analysis at 12 months.

In a modified intention to treat analysis, those who received the intervention:

• Were less likely to have an asthma exacerbation (26.9% vs 47.2%; P=.01)
• Had a lower asthma exacerbation rate (0.8 vs 1.9; P=.02)
• Had better asthma control (19.9 vs 18.6; P=.08)
• Had a higher asthma self-management score (8.9 vs 8.4; P=.04)

The researchers also used a mixed model analysis to control for potential confounding factors. A decrease in asthma exacerbations (P=.046) and asthma exacerbation rate (P=.016) remained statistically significant in the intervention cohort, while asthma control and self-management did not. No other significant differences were observed.

Source: Baptist AP, Karamched KR, Carpenter L, et al. A self-regulation intervention can decrease asthma exacerbations among older adults. Abstract #656. Presented at the 2018 AAAAI Annual Meeting, March 2-5, 2018, Orlando, FL.