This is a randomized, controlled study that will compare two medication adherence strategies
in adults with moderate or severe persistent asthma as a method for improving or maintaining
Low-income minority adults have excessively high rates of morbidity from asthma. Poor
medication adherence has been documented in these individuals and contributes to the high
morbidity level. This study will compare a Problem Solving intervention with an Attention
Control intervention to improve and sustain asthma self-management in a clinical setting.
This study will include strategies to address contextual factors related to adherence.
Participants will be recruited from clinics that serve minority and low-income individuals.
- Receiving treatment for asthma at one of the participating clinics
- Moderate or severe persistent asthma according to the NHLBI Guidelines
- Current use of prescribed inhaled corticosteroids
- Evidence of reversible airflow obstruction, as indicated by the following two
1. FEV1pp AND less than 80% at the time of study entry or within the 3 years prior
to study entry
2. An increase of greater than 15% and 200ml in FEV1 with asthma treatment over the
last 3 years (if there is no record of such improvement, participants will be
evaluated via spirometry pre- and post-bronchodilator at the first study visit.
An increase in FEV1 or FVC greater than 12% and 200 ml in FEV1 30 minutes
following albuterol administration will represent evidence of reversible airflow
obstruction. If a spirometer is not immediately available, participants may be
evaluated using a peak flow meter, which reports a PEF. A PEFpp less than 80%
and an improvement of at least 60 L per minute after the administration of
albuterol will represent evidence of reversible airflow obstruction)
- Has a functional telephone or mobile phone
- Significant lung or cardiac disease (other than hypertension)
- Psychiatric illness, such as mania or schizophrenia, that may make it impossible to
understand or carry out the Problem Solving intervention