Asia Pac Allergy.
2018 Jan;8(1):e1. 10.5415/apallergy.2018.8.e1.
Multifaceted interventions to reduce acute exacerbations in elderly asthmatics
- Affiliations
-
- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea. kimss@snu.ac.kr
- 2Seoul National University Hospital Healthcare System Gangnam Center, Seoul 06236, Korea.
- 3Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea.
- 4Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- 5Department of Internal Medicine, Pusan National University School of Medicine, Busan 50612, Korea.
- 6Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.
- 7Department of Internal Medicine, Chosun University Medical School, Gwangju 61452, Korea.
- 8Department of Allergy and Clinical Immunology, Asan Medical Center, Seoul 05505, Korea.
- 9Department of Internal Medicine, Samsung Medical Center, Seoul 06351, Korea.
- 10Department of Internal Medicine, Dankook University College of Medicine, Choenan 31116, Korea.
- 11Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea.
- KMID: 2428868
- DOI: http://doi.org/10.5415/apallergy.2018.8.e1
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.
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