Maintenance of an Asthma Intervention Post-Trial: Use of a Patient-Activated Reliever-Triggered Inhaled Corticosteroid (PARTICS) Strategy in Black and Latinx Patients

Abstract

Purpose: A Patient-Activated Reliever-Triggered Inhaled Corticosteroid (PARTICS) strategy of enhancing usual care with rescue short-acting beta agonist (SABA) supplemented with inhaled corticosteroid (ICS) reduces asthma exacerbations vs. usual care alone in Black and Latinx adults with moderate-severe asthma. We investigated post-trial PARTICS usage and patient perceptions of efficacy.

Methods: PREPARE trial participants randomized to the PARTICS intervention were surveyed an average of 29 months after trial exit.

Results: Of 600 PARTICS-assigned PREPARE trial participants, 505 consented to future research. Fifty-two percent (262/505) completed this survey. Forty-one percent (108/262) continued using PARTICS post-trial. Of these, 97% (105/108) reported that PARTICS helped to control their asthma. Thirty-four percent (37/108) switched from the trial provided QVAR® to other ICS brands due to insurance coverage or clinician issues (e.g., unwillingness to prescribe or misunderstanding of PARTICS; 65%, 24/37). Of those who stopped using PARTICS post-trial (59% [154/262]), 62% (95/154) reported using PARTICS until the PREPARE-provided ICS inhaler ran out, and 31% (47/154) reported not knowing that their asthma care clinician could prescribe it. Only 2% (5/154) of those not using PARTICS reported that it had not been helpful for asthma.

Conclusions: Continued PARTICS use was common >2 years post-trial despite minimal study instruction and was perceived as helpful for asthma, suggesting that patients will likely adopt this strategy if implemented at a healthcare system level.

Keywords: Asthma; Black or African American; Bronchodilator; Clinical trial; Healthcare Systems; Implementation Science; Latinx; Metered Dose Inhalers; Minority Health; Patient-Centered Care.