Multifaceted interventions to reduce acute exacerbations in elderly asthmatics
10.5415/apallergy.2018.8.e1
- Author:
So Hee LEE
1
;
Woo Jung SONG
;
Heung Woo PARK
;
Min Gyu KANG
;
Sae Hoon KIM
;
Hye Kyung PARK
;
Sang Heon KIM
;
Yong Eun KWON
;
Tae Bum KIM
;
Byung Jae LEE
;
Young Koo JEE
;
Byung Whui CHOI
;
Sang Heon CHO
;
Sun Sin KIM
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea. kimss@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Asthma;
Aged;
Excerbation;
Education
- MeSH:
Aged;
Asthma;
Caregivers;
Cohort Studies;
Education;
Follow-Up Studies;
Forced Expiratory Volume;
Humans;
Magnesium;
Micronutrients;
Nebulizers and Vaporizers;
Prospective Studies;
Risk Factors;
Text Messaging;
Vital Capacity
- From:
Asia Pacific Allergy
2018;8(1):e1-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Although many risk factors are known to be associated with poor asthma outcomes in the elderly, the literature on the effect of risk factor control on asthma outcomes in the elderly is very sparse. OBJECTIVE: To evaluate the role of multifaceted interventions in reducing acute exacerbations in elderly asthmatics. METHODS: A total of 100 subjects were randomly selected from our prospective cohort of elderly asthmatics aged 65 years or older and were provided multifaceted intervention for 1 year. Our multifaceted interventions included repeated education on asthma and inhaler technique for patients and their caregivers, provision of an action plan to cope with acute exacerbations, short message service to prevent follow-up losses, and oral replacement of magnesium. The primary outcome was an acute asthma exacerbation rate compared to the previous year. RESULTS: Ninety-two subjects completed this study, although only 58 subjects continued to take magnesium. Compared to the previous year, the acute asthma exacerbation rate showed a significant reduction from 67% to 50% (p = 0001) and significant improvement was observed in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (p = 0.04, p = 0.036 for each). Interestingly, a subgroup analysis revealed that predicted value of FEV1 increased significantly in subjects who continued to take magnesium from 79.6% to 87.1% (p = 0.008). CONCLUSION: To reduce acute exacerbations in elderly asthmatics, a multifaceted approach in increase medical awareness, proficiency and adherence to inhaler, assistance of caregivers and correction of micronutrients deficiency is likely to be effective. In addition, a continuous oral replacement of magnesium may increase FEV1 in elderly asthmatics.
