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

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.