News @ JSI
Efforts to Reduce Asthma in Older Adults in MA Found Successful
June 19, 2018
For older adults with asthma, breathing freely can be a struggle. Asthma affects thousands of people in Massachusetts (one of every 11), making it the 10th highest percentage in the nation. According to state data, asthma is poorly controlled in 4 of 5 adults age 65 and older who have the condition.
Older adult residents have the highest mortality rate and the second-highest hospitalization rate for asthma. Challenges often include asthma self-management as well as many experiencing additional barriers that include the inability to afford medicine and multiple health problems. These can be compounded by cultural and language barriers and the stresses associated with racial discrimination and poor housing conditions. Hispanic and black non-Hispanic people in Massachusetts are several times more likely to be hospitalized than are white people.
The Reducing Older Adults Asthma (ROAAD) study was designed to mitigate these challenges by bringing care and education directly to patients of the Lowell Community Health Center (LCHC). The study was completed by the Massachusetts Department of Public Health, LCHC, and the University of Massachusetts Lowell and hopes to become a model for future programs nationwide. The results were analyzed by JSI Research & Training Institute, Inc. The study assessed the feasibility of community health workers (CHWs) and nursing teams in a home-visiting program to improve asthma control and quality of life in older adults.
It was found that patients experienced reduced asthma symptoms and better medication use after the program. Patients reported that their asthma bothered them less after the program than before, and the percent of asthma-related hospitalizations decreased from 16.7 at the beginning of the study to 4.7 percent by the end. A total of 98 patients enrolled and 85 completed the study.
Those enrolled in the study received five in-home visits and one 12-month follow-up call, during which CHWs provided asthma self-management education, identified triggers in the home environment, and made referrals for medical, legal, housing, transportation, and social services as needed. Nurses also provided medication instruction and helped implement an asthma action plan for each patient.
“My asthma is under control now and I want to keep it that way,” one participant said. Barriers to health care also decreased over the course of the study due to new connections to resources facilitated by the CHWs. What’s more, the percent of patients who could not afford asthma medication went from 12.9 to 4.7 percent.
“For asthma, going into the home is key to understanding what triggers might be in the environment,” said an LCHC physician.
The ROAAD study, funded by the MA Office of the Attorney General, is one of few home visiting programs in the nation that included older adults who have asthma. It paves the way for future studies to test multiple sites and enroll a larger patient pool. The model offers promise for serving patients of all ages and who have other chronic conditions.
"Accountable care organizations are looking at improvement in health outcomes, capping the total cost of care, and improving efficiencies in the system. This model definitely helps achieve all of those," said Chief of Community Health and Policy at LCHC Sheila Och.
On Tuesday, June 19th a team of researchers will be presenting the findings of the two-year-long ROAAD study to health providers at noon and the public at 1:30 p.m. EST at LCHC. For more information, contact: Mercy Anampiu, MercyAn@lchealth.org, or call (978) 937-9700.