Improving Asthma Care for the Elderly: A Randomized Controlled Trial Using a Simple Telephone Intervention

Abstract

Background. Several studies suggest that asthma is undertreated in the elderly population. Objective. To determine if the use of a simple telephone intervention can improve asthma care in the elderly. Methods. Fifty-two elderly subjects with asthma who required their rescue inhalers more than twice a week and had at least one emergency department or urgent care visit in the previous year were randomized to an intervention or control group. All subjects received two telephone calls over a 12-month period. The intervention group received an asthma-specific questionnaire and the control group received a general health questionnaire. Medication use and health care utilization were evaluated at the beginning and end of a 12-month period. Results. The study was completed by 23 control and 25 intervention subjects. Baseline data were similar in both groups. After 12 months, 72% (n = 18) of the intervention group were on an inhaled corticosteroid compared with 40% (n = 10) of the control group (p = 0.08). The intervention group had fewer emergency department visits when compared with the control group (p = 0.21). Sixty-four percent (n = 16) of the intervention group had an asthma action plan compared with 26% (n = 6) in the control group (p = 0.01). Conclusion. This study suggests that asthma care in the elderly can be improved using a simple telephone intervention. Clinical implications. Clinicians need to recognize that under treatment of asthma in the elderly still exists and to use alternative methods such as a simple telephone questionnaire to improve care in this population.

Keywords:

• asthma
• elderly
• geriatric
• telephone
• questionnaire
• intervention
• health outcome