Patient characteristics associated with improvements in asthma control and reduction in emergency department visits for older adults with asthma

Alex D. Federman*, Erin Thanik, Rachel O’Conor, Arushi Arora, Michael S. Wolf, Juan P. Wisnivesky

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To identify patient characteristics associated with improvements in asthma control among older adults with asthma. Methods: Secondary analysis of data from a randomized controlled trial of an asthma self-management support intervention for adults ages 60 and older with moderate-severe persistent asthma (n = 391). We tested the association of baseline patient characteristics with reduced emergency department (ED) visits and improvement in asthma control equal to or exceeding the minimal clinically important difference (MCID) in asthma control test (ACT) scores (3.0) 12 months. Results: At baseline, the mean age was 68 years, 15.0% were male, 30.3% were black, and 56.5% were Hispanic. Patients with a history of ED visits in the 12 months preceding study enrollment were significantly more likely to experience an ED visit during the study period (adjusted odds ratio [AOR] 6.92, 95% confidence interval [CI] 2.18–21.9, p <.0001). Similarly, those with poorer asthma control (baseline ACT scores <13) had greater odds of achieving improved asthma control (AOR 13.7, 95% CI 5.32–35.1, p <.0001). No other variables had statistically significant associations with the outcomes. Conclusions: Low scores on the asthma control test and prior ED visits for asthma are strong correlates of later clinically meaningful changes in asthma control among older adults. Health systems preparing for population management of patients with asthma ought to consider incorporating serial collection of data on the ACT into the monitoring and management of older asthmatics, a high-risk patient population.

Original languageEnglish (US)
JournalJournal of Asthma
DOIs
StateAccepted/In press - 2020

Keywords

  • Geriatric
  • control/ management
  • morbidity and mortality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Fingerprint Dive into the research topics of 'Patient characteristics associated with improvements in asthma control and reduction in emergency department visits for older adults with asthma'. Together they form a unique fingerprint.

  • Cite this