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CompletedNCT03300752Updated Sep 28, 2021Results posted

Validation of the BREATHE Asthma Intervention Trial

An interventional study of BREATHE Intervention and Control Intervention in Asthma, sponsored by Columbia University. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-09-28.

Sponsored by Columbia University · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The overall goal of this study to preliminarily validate a novel intervention delivered by primary care providers (PCPs) to their Black adult patients with uncontrolled asthma in federally qualified health centers (FQHCs).

Read the detailed description

Nearly every asthma related hospitalization and death could be prevented with appropriate self-management that achieves and maintains disease control. However, as many as 64% of adults have uncontrolled asthma; minorities are disproportionately represented within that population. While inhaled corticosteroids (ICS) are a safe and effective treatment for uncontrolled asthma, relative to Whites, Blacks have lower rates of ICS adherence.

Black adults with uncontrolled asthma experience profound health disparities. Despite data that point to the critical need for enhanced asthma self-management, rates of controlled asthma are well below Healthy People 2020 targets, particularly among vulnerable populations. This Brief Evaluation of Asthma Therapy (BREATHE) intervention has the potential to offer a new avenue to asthma control via shared decision-making that supports ICS adherence.

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Conditions studied

  • Asthma

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

PROVIDER RECRUITMENT

Inclusion Criteria:

  • PCPs (MDs and Nurse Practitioners (NPs)/Physician Assistants (PAs)) working in family, primary or internal medicine care services
  • Who have at least 40 adult patients with persistent asthma (defined as having been prescribed ICS) on their patient panel

Exclusion Criteria:

  • PCPs whose primary focus is outside of adult health services (family, primary or internal medicine), such as behavioral health, pediatrics and Obstetrics and Gynaecology (OB-GYN)

PATIENT RECRUITMENT

Inclusion Criteria:

Patients must be

  1. adults (> or = 18 years of age) who self-report race as Black or African American
  2. with PCP-diagnosed persistent asthma
  3. prescribed ICS
  4. receiving asthma care at participating FQHCs
  5. who have uncontrolled asthma
  6. have erroneous personal health and/or negative ICS beliefs

Exclusion Criteria:

  1. participation in Phase 1 (Part 1) of the BREATHE trial (focus groups)
  2. non-English speaking
  3. serious mental health conditions (e.g., psychosis) that preclude completion of study procedures or confound analyses
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Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
80 participants (actual)

Study arms

  • Experimental
    BREATHE Intervention

    The patient's primary care provider (PCP) will deliver the active intervention (shared decision-making discussion of asthma control status and treatment) - BREATHE Intervention.

    Behavioral: BREATHE Intervention

  • Active comparator
    Control Intervention

    The patient's primary care provider (PCP) will deliver the control intervention (discussion of healthy lifestyles).

    Behavioral: Control Intervention

Interventions

  • BehavioralBREATHE Intervention

    PCPs randomized to BREATHE will receive the tablet which, when the screen is advanced by the PCP, will prompt the PCP through a 7-minute, 4-step brief intervention tailored to respond to the patient's specific beliefs, and shared decision-making discussion of asthma control status and treatment.

  • BehavioralControl Intervention

    PCP will provide discussion of healthy lifestyles.

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What researchers measure

Primary outcomes

  1. Asthma Control Questionnaire (ACQ) Score

    Full title: Asthma Control Questionnaire Construct measured: self-reported asthma control Scoring: 0 points = total asthma control/ best outcome, 6 points = completely uncontrolled asthma/ worst outcome

    Time frame: Baseline, 1 Month, 2 Months, 3 Months (post-intervention)

Secondary outcomes

  1. Asthma Quality of Life Questionnaire (AQLQ) Score

    Full title: Asthma Quality of Life Questionnaire Construct: quality of life for patients with asthma Scoring: 32 items, each scored 1-7. The total score is calculated as a mean of all 32 items (1= low quality of life/ worse outcome, 7= high quality of life/ best outcome)

    Time frame: Baseline, 1 Month, 2 Months, 3 Months (post-intervention)

  2. Medication Adherence Record Scale-Asthma (MARS-A) Score

    Full title: Medication Adherence Record Scale- Asthma Construct: Adherence to inhaled corticosteroid medications Scoring: Total score is calculated as a mean of the 10 items, scores range from 1-5 (1= low adherence/ worse outcome, 5= high adherence/ best outcome)

    Time frame: Baseline, 1 Month, 2 Months, 3 Months (post-intervention)

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Results

Posted Sep 28, 2021

Participant flow

Participant flow — Overall Study
MilestoneBREATHE InterventionControl Intervention
Started4040
Completed3838
Not completed22

Outcome measures

PrimaryAsthma Control Questionnaire (ACQ) Score

Full title: Asthma Control Questionnaire Construct measured: self-reported asthma control Scoring: 0 points = total asthma control/ best outcome, 6 points = completely uncontrolled asthma/ worst outcome

Time frame:
Baseline, 1 Month, 2 Months, 3 Months (post-intervention)
Reported as:
Mean · score on a scale
Asthma Control Questionnaire (ACQ) Score
score on a scaleBREATHE InterventionControl Intervention
Baseline2.94 ± 0.152.63 ± 0.15
1-month post2.17 ± 0.172.16 ± 0.16
2-month post2.22 ± 0.162.35 ± 0.16
3-month post2.40 ± 0.152.24 ± 0.15
SecondaryAsthma Quality of Life Questionnaire (AQLQ) Score

Full title: Asthma Quality of Life Questionnaire Construct: quality of life for patients with asthma Scoring: 32 items, each scored 1-7. The total score is calculated as a mean of all 32 items (1= low quality of life/ worse outcome, 7= high quality of life/ best outcome)

Time frame:
Baseline, 1 Month, 2 Months, 3 Months (post-intervention)
Reported as:
Mean · score on a scale
Asthma Quality of Life Questionnaire (AQLQ) Score
score on a scaleBREATHE InterventionControl Intervention
Baseline3.50 ± 0.183.65 ± 0.18
1-month post4.03 ± 0.204.07 ± 0.19
2-month post3.97 ± 0.194.18 ± 0.19
3-month post4.02 ± 0.184.22 ± 0.18
SecondaryMedication Adherence Record Scale-Asthma (MARS-A) Score

Full title: Medication Adherence Record Scale- Asthma Construct: Adherence to inhaled corticosteroid medications Scoring: Total score is calculated as a mean of the 10 items, scores range from 1-5 (1= low adherence/ worse outcome, 5= high adherence/ best outcome)

Time frame:
Baseline, 1 Month, 2 Months, 3 Months (post-intervention)
Reported as:
Mean · score on a scale
Medication Adherence Record Scale-Asthma (MARS-A) Score
score on a scaleBREATHE InterventionControl Intervention
Baseline3.95 ± 0.123.88 ± 0.12
1-month post4.07 ± 0.134.12 ± 0.12
2- month post4.28 ± 0.124.18 ± 0.12
3-month post4.08 ± 0.124.03 ± 0.12

Adverse events

Collected over Up to 3 months post-intervention. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
BREATHE Intervention1/40 (2.5%)1/40 (2.5%)5/40 (12.5%)
Control Intervention1/40 (2.5%)0/40 (0%)2/40 (5%)
Most frequent serious events
Most frequent serious events
EventBREATHE InterventionControl Intervention
presumed myocardial infarctionCardiac disorders1/400/40
Most frequent other events
Most frequent other events
EventBREATHE InterventionControl Intervention
emergency department visitRespiratory, thoracic and mediastinal disorders5/402/40

Baseline characteristics

Age, Continuous
Age, Continuous(years)BREATHE InterventionControl InterventionTotal
Mean47.35 ± 12.8042.9 ± 13.0645.1 ± 13.1
Sex: Female, Male
Sex: Female, Male(Participants)BREATHE InterventionControl InterventionTotal
Female303666
Male10414
Race (NIH/OMB)
Race (NIH/OMB)(Participants)BREATHE InterventionControl InterventionTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American383573
White000
More than one race257
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)BREATHE InterventionControl InterventionTotal
United States404080
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Study locations

1 site
  • Columbia University Medical Center
    New York, New York 10032, United States
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References and documents

Publications

  • George M, Pantalon MV, Sommers MLS, Glanz K, Jia H, Chung A, Norful AA, Poghosyan L, Coleman D, Bruzzese JM. Shared decision-making in the BREATHE asthma intervention trial: A research protocol. J Adv Nurs. 2019 Apr;75(4):876-887. doi: 10.1111/jan.13916. Epub 2019 Jan 24. PubMed 30479020 ↗
  • George M, Bruzzese JM, Lynn S Sommers M, Pantalon MV, Jia H, Rhodes J, Norful AA, Chung A, Chittams J, Coleman D, Glanz K. Group-randomized trial of tailored brief shared decision-making to improve asthma control in urban black adults. J Adv Nurs. 2021 Mar;77(3):1501-1517. doi: 10.1111/jan.14646. Epub 2020 Nov 29. PubMed 33249632 ↗

Study documents

  • Protocol and statistical analysis plan · Mar 8, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT03300752
Lead sponsor
Columbia University
Responsible party
Maureen George (Associate Professor of Nursing at the Columbia University Medical Center, Nursing Scholarship & Research, Columbia University) — Principal investigator
First posted
Oct 3, 2017
Start date
Oct 1, 2017
Primary completion
May 29, 2019
Completion
May 30, 2019
Results posted
Sep 28, 2021
Last update
Sep 28, 2021

Study contacts

Maureen George, PhD
principal investigator · Associate Professor of Nursing at Columbia University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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