PCORI has identified childhood asthma in African Americans and Hispanics/Latinos as an important research topic. Asthma affects African-American and Hispanic/Latino people at higher rates than whites, but African-American and Hispanic/Latino children are less likely to receive recommended care. Patients, clinicians, and others want to learn: What interventions will best help doctors and families assure that children receive the care recommended by the National Heart, Lung, and Blood Institute? To answer this question, PCORI launched a funding initiative in 2013 on Treatment Options for African Americans and Hispanics/Latinos with Uncontrolled Asthma. This research project is one of the studies PCORI awarded as part of this program.
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Asthma is a common condition that makes it hard to breathe because of swelling in the airways. Millions of Americans have asthma, but it is more common among African Americans than it is among whites. African Americans are more likely than whites to have other health problems because of their asthma. They have more asthma symptoms and visit the emergency room more often. They are also more likely to die from asthma.
African-American children are less likely than white children to be prescribed asthma medicine or to follow a treatment plan. Daily medicines (such as inhaled corticosteroids) can improve asthma symptoms. There are two ways to manage asthma using daily medicine.
One approach is controlled by the doctor. This is called guideline-based physician adjustment. The doctor talks with the family about the child’s symptoms and decides how often the child should take the medicine. This approach may not work if parents and children are not able to visit the doctor regularly or if they usually get care in the emergency room.
The other approach is controlled by the patient. This is called symptom-based adjustment. The doctor encourages the patient to use the daily asthma medicine. The patient takes a rescue medicine and their daily medicine when he or she has symptoms. This approach has worked in small studies, but researchers do not know how well it works in daily life for African-American children.
In this study, the research team is comparing these two ways of managing asthma in African-American children.
Who can this research help?
Information from this study can help doctors and African-American children with asthma and their parents make choices about how to manage the disease.
What is the research team doing?
This research study is comparing the doctor-controlled way of managing asthma to the patient-controlled way. The research team wants to find out how the two approaches affect asthma symptoms, how much medicine patients use, and how happy patients and their families are with their treatments.
The research team is recruiting 206 African-American children with asthma from primary care clinics. The research team is assigning these children by chance to one of two groups. One group uses the doctor-controlled way of managing asthma. Doctors adjust how much medicine patients should take during office visits or by phone contact. Patients in the other group use a rescue inhaler along with their daily asthma medicine when they have symptoms. The children or their parents fill out a survey at the beginning of treatment and again every three months for a year. The survey asks how asthma affects their daily lives and how often they have asthma attacks. The research team also tests patients’ lung function again at the end of the year.
The research team is working with a group of parents, older African-American children with asthma, and doctors to help guide the study.