Shared decision-making in the BREATHE asthma intervention trial: A research protocol

Area of Science:

• Clinical Medicine
• Public Health
• Health Disparities

Background:

• Asthma disproportionately affects minority populations, leading to significant health disparities.
• Erroneous beliefs about asthma and its treatment contribute to poor medication adherence and uncontrolled disease.
• Shared decision-making (SDM) is effective but often requires intensive resources, limiting its real-world application.

Purpose of the Study:

• To evaluate the preliminary effectiveness of the BRief Evaluation of Asthma THerapy (BREATHE) intervention.
• BREATHE is a primary care provider-delivered, 7-minute SDM protocol using motivational interviewing.
• The intervention aims to address erroneous asthma disease and medication beliefs in Black adults with uncontrolled asthma.

Main Methods:

• A multi-center, masked, two-arm group-randomized pilot trial.
• Eight providers were randomized to the BREATHE intervention (N=4) or an attention control (N=4).
• Eighty Black adult patients with uncontrolled asthma received the intervention from their randomized provider and were followed for 3 months.

Main Results:

• The study assessed preliminary effects on asthma control (primary outcome).
• Secondary outcomes included medication adherence, lung function, and asthma-related quality of life.
• Results will inform the design of a future large-scale randomized trial.

Conclusions:

• The BREATHE intervention shows promise for improving asthma control in Black adults by addressing disease and medication beliefs.
• Adapting SDM interventions for real-world settings is crucial for sustainability and addressing health disparities.
• This pilot study provides a foundation for testing a novel, multifactorial approach to improve asthma management in underserved populations.