Elliot Israel|J.C. Cardet|Jennifer K. Carroll|Anne L. Fuhlbrigge|Lilin She|Frank W. Rockhold|Nancy Maher|Maureen Fagan|Victoria E. Forth|Barbara P. Yawn|Paulina Arias Hernandez|Jean Kruse|Brian Manning|Jacqueline Rodriguez-Louis|Joel Shields|Brianna Ericson|Alex D. Colon-Moya|Suzanne Madison|Tamera Coyne?Beasley|Gretchen Hammer|Barbara Kaplan|Cynthia S. Rand|Janet Robles|Opal Thompson|Michael E. Wechsler|Juan P. Wisnivesky|M. Diane McKee|Sunit Jariwala|Elina Jerschow|Paula J. Busse|David C. Kaelber|Sylvette Nazario|Michelle Hernández|Andrea J. Apter|Ku-Lang Chang|Víctor Pinto-Plata|Paul M. Stranges|Laura P. Hurley|Jennifer Trevor|Thomas B. Casale|Geoffrey Chupp|Isaretta Riley|Kartik Shenoy|Magdalena Pasarica|R.A. Calderon Candelario|Hazel Tapp|Ahmet Baydur|Wilson Pace
Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma
Brigham and Women's Hospital|Harvard University|University of South Florida|American Academy of Family Physicians|Pulmonary and Critical Care Associates|Duke Medical Center|Clinical Research Institute|Duke Medical Center|Clinical Research Institute|Brigham and Women's Hospital|Harvard University|University of Miami Health System|Brigham and Women's Hospital|Harvard University|University of Minnesota|Brigham and Women's Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|American Academy of Family Physicians|Brigham and Women's Hospital|Harvard University|National Patient Safety Foundation|American Academy of Family Physicians|Brigham and Women's Hospital|Harvard University|Office of Adolescent Health|University of Colorado Denver|University of Colorado Anschutz Medical Campus|American Lung Association|Johns Hopkins University|National Patient Safety Foundation|Brigham and Women's Hospital|Lahey Medical Center|University of South Florida|Lahey Hospital and Medical Center|National Jewish Health|University of Colorado Denver|General Department of Preventive Medicine|Albert Einstein College of Medicine|Albert Einstein College of Medicine|Icahn School of Medicine at Mount Sinai|Montefiore Medical Center|MetroHealth Medical Center|Case Western Reserve University|MetroHealth|MetroHealth|University of Pennsylvania|Florida College|University of Florida|Lahey Medical Center|University of Illinois at Chicago|Hospital Authority|University of Alabama at Birmingham|University of South Florida|Yale University|Duke University|MetroHealth|Temple Lung Center|Temple University|University of Central Florida|Florida College|University of Miami|MetroHealth|University of Southern California
black latinx patients bear disproportionate burden asthma efforts reduce disproportionate morbidity mostly unsuccessful guideline recommendations based studies populationsin pragmatic openlabel trial randomly assigned black latinx adults moderatetosevere asthma use patientactivated relievertriggered inhaled glucocorticoid strategy beclomethasone dipropionate 80 g plus usual care intervention continue usual care participants one instructional visit followed 15 monthly questionnaires primary end point annualized rate severe asthma exacerbations secondary end points included monthly asthma control measured asthma control test act range 5 poor 25 complete control quality life measured asthma symptom utility index asui range 0 1 lower scores indicating greater impairment participantreported missed days work school usual activities safety also assessedof 1201 adults 603 black 598 latinx 600 assigned intervention group 601 usualcare group annualized rate severe asthma exacerbations 069 95 confidence interval ci 061 078 intervention group 082 95 ci 073 092 usualcare group hazard ratio 085 95 ci 072 0999 p 0048 act scores increased 34 points 95 ci 31 36 intervention group 25 points 95 ci 23 28 usualcare group difference 09 95 ci 05 12 asui scores increased 012 points 95 ci 011 013 008 points 95 ci 007 009 respectively difference 004 95 ci 002 005 annualized rate missed days 134 intervention group 168 usualcare group rate ratio 080 95 ci 067 095 serious adverse events occurred 122 participants even distribution groupsamong black latinx adults moderatetosevere asthma provision inhaled glucocorticoid onetime instruction use added usual care led lower rate severe asthma exacerbations funded patientcentered outcomes research institute others prepare clinicaltrialsgov number nct02995733