The Impact of Patient Autonomy on Older Adults with Asthma

RATIONALE: Understanding patient preferences and desire for involvement is crucial in managing medical conditions. Previous studies have utilized the Autonomy Preference Index (API) in younger patients with asthma to evaluate and recognize their preferences. The purpose of this study was to assess whether the API score can impact asthma related outcomes among older adults with asthma.

METHODS: 189 older adults (>55) with persistent asthma were included. Preferences for autonomy were assessed using the API, with a higher score indicating a higher desire for autonomy. Scores were separated into the two domains of ‘information seeking’ preferences and ‘decision making’ preferences. The separated scores were correlated with asthma specific outcomes and demographic variables. To further control for confounding variables, a linear regression analysis was performed.

RESULTS: Higher decision making preference scores were correlated with male gender (p=0.007), higher spirometry values (p=0.07), higher asthma quality of life questionnaire (AQLQ) scores (p=0.01), and lower depression scores (p=0.04). On linear regression analysis, only the AQLQ score remained significantly associated with the decision making preference score (p=0.02). There was no association with ACT score, spirometry values, and healthcare utilization. There was no correlation with information seeking preference scores and other variables.

CONCLUSIONS: A higher decision making preference score of the API is associated with a higher quality of life in older adults with persistent asthma. Further longitudinal studies may help establish a potential causal relationship.