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Tuesday, December 20, 2016

Patient-centered outcomes research to improve asthma outcomes

Asthma is a devastating chronic disease that affects up to 24 million Americans.  It is more severe and prevalent among African Americans and Hispanics, especially Puerto Ricans.  There’s a two-fold increase in asthma mortality in Hispanic children and three-fold among African Americans, compared to Whites.  The causes of these disparities are complex, but are undoubtedly worsened by the observation that they are less likely to be treated according to the National Asthma Education Prevention Program (NAEPP) guidelines, which have been widely available for the past 20 years.  To address these issues, the Patient-Centered Outcomes Research Institute (PCORI) funded 8 studies to help patients and clinicians adhere to the guidelines.  In this month’s issue of the Journal of Allergy and Clinical Immunology, Anise and colleagues review these 8 randomized control trials (J Allergy Clin Immunol 2016; 138(6): 1503-1510).

Among the approaches being used are (1) clinician education, (2) clinical decision support, (3) patient education in the ER and clinic, (4) use of community health workers, and (5) use of long-term and quick-relief medications.    While each study has a distinct focus, all of them overlap in incorporating relevant stakeholders into the projects, and aligning local resources towards overarching, generalizable goals. 

The research projects are still underway, and results will not be available for at least two more years.  But these research projects are pioneering in the way that they are putting research in action in local communities, and embracing multi-faceted approaches with the understanding that single interventions may not be effective.

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