656:
A Self-Regulation Intervention Can Decrease Asthma Exacerbations Among Older Adults
Monday, March 5, 2018
South Hall A2 (Convention Center)
Alan P. Baptist, MD MPH FAAAAI, Keerthi R. Karamched, MD, Laurie Carpenter, MSW, Wei Hao, MA, Peter X Song, PhD, Joel Steinberg
RATIONALE: Older adults have high rates of asthma morbidity and mortality compared to younger age groups. The purpose of this study was to evaluate a self-management asthma intervention as a means to decrease asthma exacerbations.

METHODS: Adults age 55 and above with persistent asthma were enrolled into blinded, randomized controlled trial of a 6-session asthma self-management intervention. This educational intervention was conducted in group sessions and through individual telephone calls. Outcomes including asthma exacerbations (defined as unscheduled office visits, emergency department visits, or hospitalizations for asthma), spirometric values, FeNO, asthma control, asthma quality of life, and asthma self-management were assessed at 3, 6, and 12 months.

RESULTS: 189 subjects were enrolled, 172 were randomized and received at least one treatment dose, and 145 (84%) were analyzed at 12 months. On a modified intent to treat analysis, those in the intervention group were less likely to have an asthma exacerbation (26.9% vs 47.2%, p = 0.01), had a lower asthma exacerbation rate (0.8 vs 1.9, p = 0.02), had better asthma control (19.9 vs 18.6, p = 0.08) and had a higher asthma self-management score (8.9 vs 8.4, p = 0.04). After a mixed model analysis to control for potential confounding factors, a decrease in asthma exacerbations (p = 0.046) and a decreased asthma exacerbation rate (p = 0.016) remained statistically significant while asthma control and self-management did not. No other significant outcome differences were found.

CONCLUSIONS: A 6 session self-management intervention can successfully decrease asthma exacerbations among older adults.