A pilot randomized controlled trial of an intervention to improve perception of lung function in older adults with asthma

Abstract

Asthma affects 6–8% of the United States population aged 65 years and older (1). This age group, particularly minoritized populations, has the highest hospitalization and mortality rates for asthma (2). Older adults with asthma may be more likely to underperceive airflow obstruction (3), which is linked to an elevated risk of near-fatal and fatal asthma attacks and increased morbidity (4). Correction of underperception of airflow obstruction in children through training to estimate peak expiratory flow (PEF) followed by feedback of seeing actual PEF led to improved controllermedication adherence (5). However, there are no data regarding the potential benefits of addressing underperception in older adults. The objective of this pilot randomized controlled trial was to compare PEF feedback combined with motivational interviewing (MI), a counseling intervention for eliciting behavior change by helping patients explore and resolve ambivalence (6), to a control group on the perception of airway obstruction (primary endpoint), PEF values, self-reported asthma control, andmedication adherence.