Researchers recently conducted an individualized randomized controlled trial to improve inhaled steroid adherence and asthma outcomes. Their findings appear in The Journal of Allergy and Clinical Immunology.
The study looked at adults with moderate/severe asthma, who were recruited from practices serving inner-city neighborhoods. The researchers compared problem-solving (PS) to standard asthma education (AE) over 6 months. PS consisted of defining specific barriers to adherence, proposing solutions, trying the best, assessing, and revising.
Overall, 333 adults were randomized—49+14 years, 72% female, 68% African American, 7% Latino, mean FEV1 66%+19%, 31% with hospitalizations, and 52% with emergency department (ED) visits for asthma in the prior year.
The findings show no difference between groups in overall change of adherence or any asthma outcomes. Mean adherence was good, according to researchers—61% declining slightly over the observation period. Asthma control improved overall by 15%. In both groups, FEV1 and quality of life improved by 6% (PS) and 18% (AE). However, the improvement in FEV1 only occurred during monitoring but not subsequently after randomization. Rates of ED visits and hospitalizations did not decrease. Thus, the researchers found that PS was not better than AE. Moreover, monitoring inhaled steroid use with provision of medications and attention, imposed on both groups, was associated with improvement in FEV1 and asthma control, but did not reduce the rates of ED visits and hospitalizations.
Source: American Academy of Allergy, Asthma & Immunology