Results Summary

What was the research about?

People with asthma may have asthma attacks that make it hard to breathe. Symptoms may include shortness of breath, tightness in the chest, coughing, or wheezing. People may need treatment with steroids when they have severe attacks, and they may also end up in the hospital. Black and Latinx people have worse asthma outcomes compared with White people.

Using an inhaler with a medicine called an inhaled corticosteroid, or ICS, every day can help control asthma. To ease asthma symptoms when they occur, people can take a fast-acting asthma medicine through a reliever inhaler or a nebulizer. With a nebulizer, patients inhale medicine through a mask. Using the ICS inhaler at the same time as the reliever inhaler or nebulizer is one way to prevent and control asthma attacks.

In this study, the research team wanted to see if adding PARTICS, or Patient-Activated Reliever-Triggered Inhaled Corticosteroid, to usual asthma care improved outcomes for Black and Latinx patients. In PARTICS, patients take one puff of an ICS inhaler each time they take a puff of their reliever inhaler. If patients use a nebulizer, they take five puffs of an ICS inhaler.

What were the results?

At 15 months, compared with patients who continued usual care alone, patients who added PARTICS to usual asthma care had:

  • Fewer severe asthma attacks 
  • Better asthma control 
  • Better quality of life
  • Fewer missed days of school or work and fewer missed usual activities

Who was in the study?

The study included 1,201 patients ages 18–75 with moderate to severe asthma. Of these, 50 percent were Black, and 50 percent were Latinx. The average age was 48, and 84 percent were women. All had asthma for at least one year and received care from one of 19 clinics across the United States. The study included people who do and don’t smoke, as well as those who used to smoke.

What did the research team do?

The research team assigned patients by chance to add PARTICS to usual care or continue usual care alone. Usual care included routine asthma treatment. All patients watched an educational video about asthma. Patients assigned to add PARTICS watched a video about how and why to use PARTICS. The team also provided ICS inhalers to patients assigned to use PARTICS.

At the start of the study and each month for 15 months, patients completed surveys about asthma.

Black and Latinx patients with asthma, doctors, and people from asthma patient advocacy and professional groups provided input during the study.

What were the limits of the study?

Most people in the study were women. Results may differ for people of other genders.

Future research could compare the effectiveness of PARTICS versus single-maintenance and reliever therapy, or SMART, which uses one inhaler every day.

How can people use the results?

Doctors and patients with asthma can use the results when considering ways to control asthma.

Final Research Report

This project's final research report is expected to be available by September 2024.

Journal Citations

Article Highlight: An easy-to-use, patient-centered approach to managing moderate to severe asthma improved outcomes for African-American/Black and Hispanic/Latino adults, according to findings of the PREPARE study published in The New England Journal of Medicine. Study participants were randomized to receive either usual care or one-time instruction to use inhaled corticosteroids (ICS) when they used an asthma reliever or nebulizer. Those in the ICS group experienced a 15 percent decreased risk of severe asthma exacerbations as well as reduced asthma symptoms and days of impairment compared to those who got usual care.

Stories and Videos

Media Mentions

Doctors Might Have Been Focusing on the Wrong Asthma Triggers: What Asthma Triggers Matter Most
Sarah Zhang, The Atlantic, July 9, 2021
The feature article highlights this study and includes comments from study Principal Investigator Elliot Israel, MD, about a decrease that he and his team observed in asthma attacks among study participants during the COVID-19 pandemic.

Peer-Review Summary

The Peer-Review Summary for this project will be posted here soon.

Conflict of Interest Disclosures

Project Information

Elliot Israel, MD
Partners Healthcare Brigham and Women's Hospital
Patient Empowered Strategy to Reduce Asthma Morbidity in Highly Impacted Populations (PESRAMHIP)

Key Dates

January 2016
June 2023

Study Registration Information


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Last updated: April 12, 2024