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Allergy and Airway |

A Multifaceted Approach to Reduce Acute Exacerbations in Elderly Asthmatics

Suh-Young Lee; Heung-Woo Park; Woo-Jung Song; Sang-Heon Cho, MD
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Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (the Republic of)


Chest. 2015;148(4_MeetingAbstracts):11A. doi:10.1378/chest.2276345
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Abstract

SESSION TITLE: Allergy and Airway Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: In our previous study, we have learned that factors related with acute exacerbations in elderly asthmatics were complex, for example, poor adherence and inhaler technique, depression, and magnesium deficiency. In this prospective study, we aimed to evaluate the role of a multifaceted approach 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. Our multifaceted approach included; repeated education on asthma and inhaler technique, 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 which comprised at least one of the followings; use of systemic corticosteroids for at least 3 days, unscheduled visit of outpatient clinic, and hospitalization or emergency room visit. The intervention period was one year and acute asthma exacerbation rate was compared to that of one year prior to this study.

RESULTS: Ninety-two subjects completed this study, although only 58 subjects continued to take magnesium. Compared to one year prior to this study, the acute asthma exacerbation rate showed a significant reduction from 67% to 50% (McNemar’s test; P = 0001). Interestingly, a subgroup analysis revealed that predicted value of forced expiratory volume in one second (FEV1) increased significantly in subjects who continued to take magnesium from 79.9% to 87.1% (P = 0.008).

CONCLUSIONS: To reduce acute exacerbations in elderly asthmatics, a multidimensional approach to increase medical awareness, inhaler technique and adherence is essential. In addition, a continuous oral replacement of magnesium may increase FEV1 in elderly asthmatics.

CLINICAL IMPLICATIONS: As the world is aging, asthma in the elderly is getting more attention. This study provides a useful strategy in managing acute exacerbations in elderly asthmatics.

DISCLOSURE: The following authors have nothing to disclose: Suh-Young Lee, Heung-Woo Park, Woo-Jung Song, Sang-Heon Cho

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