A Randomized Controlled Trial of a Self-Regulation Intervention for Older Adults with Asthma

• Published in: Journal of the American Geriatrics Society (JAGS) 2013-05, Vol.61 (5), p.747-753
• Main Authors: Baptist, Alan P., Ross, Jacqueline A., Yang, Ye, Song, Peter X. K., Clark, Noreen M.
• Format: Article
• Language: English
• Subjects: Aged; Anti-Asthmatic Agents - therapeutic use; Asthma; Asthma - physiopathology; Asthma - psychology; Asthma - therapy; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Cognitive Therapy - methods; Double-Blind Method; Female; Follow-Up Studies; Forced Expiratory Volume; General aspects; Health services utilization; healthcare utilization; Humans; Intervention; Male; Medical sciences; Miscellaneous; older adults; Older people; Patient Compliance; Pneumology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life; Respiratory Function Tests; self-regulation; Social Control, Informal - methods; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.12218

Objectives To evaluate a self‐regulation intervention for asthma for older adults. Design A blinded randomized controlled trial. Setting Single‐center tertiary care academic center. Participants Seventy older adults aged 65 and older with persistent asthma randomized to an intervention or control group. Intervention Participants participate in a six‐session program conducted over the telephone and in group sessions. Participants selected an asthma‐specific goal, identified problems, and addressed potential barriers. Measurements Outcomes were assessed at 1, 6, and 12 months and included the mini‐Asthma Quality of Life Questionnaire (mAQLQ), Asthma Control Questionnaire (ACQ), healthcare utilization, exhaled nitric oxide (FENO), and percentage of predicted forced expiratory volume in 1 second (FEV1%). Results The mAQLQ score was significantly higher in the intervention group at 1, 6, and 12 months, even after controlling for confounding factors. The between‐group difference decreased over time, although at 12 months, it remained greater than 0.5 points. The ACQ was better in the intervention group than in the control group at 1, 6, and 12 months. At 12 months, those in the intervention group were 4.2 times as likely as those in the control group to have an ACQ score in the controlled range. Healthcare utilization was lower in the intervention group, although no difference was observed in FENO or predicted FEV1%. Conclusion A self‐regulation intervention can improve asthma control, quality of life, and healthcare utilization in older adults.