Study: Home visits by community-health workers improve asthma and quality of life

Low-income adults with uncontrolled asthma saw both their asthma control and quality of life improve with the help of an in-home, self-management asthma support program delivered by community health workers (CHWs), according to a study published online today by JAMA Internal Medicine.

“The great news about this intervention is that it could be readily replicated by health organizations who work with low-income clients, reducing the high rate of poorly controlled asthma,” says Dr. Jim Krieger, Chief, Chronic Disease and Injury Prevention Section at Public Health – Seattle & King County and lead author of the study.

Asthma affects one in 12 — or 24.6 million — Americans. Control of asthma is inadequate for many, despite the availability of effective methods to manage it, leading to ongoing symptoms, poor health and missed work and school days.

Getting support for asthma at home

The Home-Based Asthma Support and Education trial (HomeBASE) study provided CHW home visits to low-income adults with poorly controlled asthma over the course of a year. When visiting, the CHWs would:

  • assess participants’ level of asthma control
  • check for the presence of asthma triggers like mold or tobacco smoke in the home
  • help participants improve their skills in controlling asthma, such as using medications correctly or acting quickly to turn around an asthma flare.

The study found that participants receiving the home visits had greater increases in the number of days they were free of asthma symptoms (2.02 days per two weeks more) and in quality of life compared to the participants who received routine asthma care without home visits. The number of urgent health care visits for asthma (i.e. hospitalizations, emergency department visits and urgent clinic visits) in the past 12 months decreased similarly in both groups by about 1.5 visits per year.

The cost per participant was approximately $1,300, substantially less than one year’s supply of a typical asthma control medication.

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