Study: Shared Decision-Making in Asthma Treatment Improves Disease Control in Urban Black Adults

New research suggests that shared decision-making interventions can help address asthma disparities among Black adults in urban settings, with study participants showing significantly better asthma control at every checkpoint during the 3-month trial.

Asthma is one of the most common chronic illnesses, affecting approximately 339 million individuals globally with an estimated 15 million disability-adjusted life-years lost due to the disease.1 According to the study authors, asthma affects approximately 19 million adults in the United States, with those living below the poverty level having a higher asthma prevalence than those above it.¹

Compared to whites and Hispanics, Black Americans have a higher prevalence of asthma and are about 3 times as likely to die of the disease, according to researchers at the Columbia University School of Nursing. To help address these disparities, investigators conducted a group-randomized longitudinal trial designed to assess the effects of a novel shared decision-making intervention.¹

The study, published in the Journal of Advanced Nursing, evaluated an intervention called BREATHE (Brief Intervention to Evaluate Asthma Therapy) to determine its efficacy, feasibility, and acceptance. Relative to a comparator group of 40 adults, the 40 individuals who participated in BREATHE showed significantly better asthma control and higher perceived shared decision-making immediately after the intervention visit with their health care provider.¹

The participants were all Black or multiracial, and 83% were female, with a mean age of 45 years. They were followed monthly for 3 months post-intervention and data were collected from December 2017 to May 2019, including surveys, lung function tests, and interviews.¹

According to the authors, BREATHE is a brief, tailored intervention that can be integrated into office visits using clinicians as the interventionists. The authors said using the patient’s own clinician as the interventionist helps keep the patient appraised of the challenges in asthma management, and the intervention could serve as a template for other patient populations with similar challenges.²

“Based on this study, BREATHE has shown to be a promising, brief, and tailored intervention that can be integrated into office visits, with clinicians as interventionists,” said lead author Maureen George, PhD, an associate professor at Columbia University School of Nursing, in a prepared statement. “We believe BREATHE is particularly useful because it’s a pragmatic, shared decision-making approach to improving asthma outcomes in a population that experiences marked health disparities.”²

REFERENCES

• George M, Bruzzese J, Sommers M, Pantalon M, et al. Group-randomized trial of tailored brief shared decision-making to improve asthma control in urban black adults. J Adv Nurs; November 29, 2020. https://pubmed.ncbi.nlm.nih.gov/33249632/. Accessed January 14, 2021.
• Group-randomized Trial Showed Significant Improvement in Asthma Control Among Urban Black Adults [news release]. Columbia University School of Nursing; December 8, 2020. https://www.nursing.columbia.edu/news/group-randomized-trial-showed-significant-improvement-asthma-control-among-urban-black-adults. Accessed January 14, 2021.