A Randomized Trial of Perception of Airflow Limitation Training to Improve Outcomes for Older Adults With Asthma

Status: Recruiting
Location: See all (2) locations...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Asthma affects 8% of the United States population ages \>60 years and causes considerable harm: older adults are 4 times more likely to die from asthma and have twice the risk of hospitalization. The burden of asthma is notably greater among minoritized older adults. Research suggests that perception of expiratory airflow limitation may be a major determinant of asthma outcomes in older adults, and that older adults are substantially less aware of airway obstruction than younger adults. These observations suggest that perception of airflow limitation is a potential target for improving outcomes of older patients with asthma. The research team completed a pilot randomized controlled trial (RCT) of an intervention that trains older adults with asthma to better perceive expiratory airway obstruction through feedback via peak expiratory flow (PEF) prediction and couples this feedback with motivational interviewing (MI) to promote change in asthma self-management behaviors. Compared to an attention control, the intervention improved PEF, perception of airflow limitation and asthma control. In this project, the research team will conduct a fully powered RCT to test the intervention's efficacy among 300 adults ages ≥60 years with uncontrolled asthma who are on controller medications (daily maintenance or as needed) recruited from underserved inner-city medical practices in New York City. Patients will be randomized to the intervention or a time and attention matched educational control. The intervention and control will be delivered in 3 sessions over 6 weeks. The study will test the impact of the intervention on perception of expiratory airflow limitation in older adults with asthma, examine the efficacy of the intervention for improvements in lung function (PEF), self-reported asthma control (Asthma Control Questionnaire \[ACQ\] scores), quality of life (Asthma Quality of Life Questionnaire \[AQLQ\] scores), and emergency department and hospital use, and test the intervention's impact on mean daily ICS dose used (daily maintenance and as needed). Data will be collected at baseline, 1-month, 6-months (primary analyses of effectiveness) and 12-months post-intervention. In secondary analyses, the research team will test the sustainability of treatment effects with vs. without the booster treatment session (active booster vs. attention control booster) delivered immediately after the 6-month assessment on outcomes at 12-months.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 60
Healthy Volunteers: f
View:

• Age \> 60 years

• English or Spanish speaking

• Self-report or physician diagnosis of asthma \>1 year ago

• Uncontrolled asthma

Locations
United States
New York
Ichan School of Medicine at Mount Sinai
RECRUITING
New York
Albert Einstein College of Medicine
NOT_YET_RECRUITING
The Bronx
Contact Information
Primary
Juan Wisnivesky, MD, DrPH
juan.wisnivesky@mountsinai.org
212-824-7845
Backup
Dhanya Chanumolu, MPH
dhanya.chanumolu@mountsinai.org
332-777-5754
Time Frame
Start Date: 2024-09-18
Estimated Completion Date: 2028-12-22
Participants
Target number of participants: 300
Treatments
Experimental: PEF group with active booster
This arm will have 3 intervention sessions over 6 weeks and an additional (active) session at 6-month time point.
Experimental: PEF group with control booster
This arm will have 3 intervention sessions over 6 weeks and a control booster session at the 6-month time point.
Placebo_comparator: Control Group
This arm will have 3 control sessions over 6 weeks and a control booster session at 6-month time point.
Related Therapeutic Areas
Sponsors
Collaborators: Albert Einstein College of Medicine, Yeshiva University, National Heart, Lung, and Blood Institute (NHLBI)
Leads: Icahn School of Medicine at Mount Sinai

This content was sourced from clinicaltrials.gov