Effectiveness of minimal educational intervention in primary care in asthmatic patients using high doses of short-acting bronchodilators.A pilot clinical trial.

Research Question Considering that there are asthmatic patients with a higher risk of exacerbation due to an inadequate use of Short-Acting Beta-Agonists (SABAs), could their prognosis be improved by an intervention in Primary Care?2* BackgroundA fundamental problem in asthma is poor adherence to maintenance treatment with inhaled corticosteroids (ICS), accompanied by an abuse of rescue medication with SABA, leading to inadequate control. Another one is related to the difficulty in the inhalation technique. Clinical practice guidelines justify educational programs with the highest level of evidence(A).Objectives: To analyze the potential effectiveness of an educational intervention in primary care in the degree of asthma control. Also, to optimize the consumption of SABA, improving adherence to maintenance treatment, the use of inhalation devices and the degree of patients' knowledge in relation to their disease.3* MethodologyType: Parallel randomized phase II clinical trial, two branches. Study population: Asthma patients over 18 years old assigned to our health center, who have withdrawn more than 6 containers of SABA. Those with a diagnosis of Chronic Obstructive Pulmonar Disease or other chronic lung diseases will be excluded.Methods: 48 patients will be selected by a consecutive random assignment, and assigned to control or educational intervention groups.Variables: Sex, age, smoking, lung function (peak-flow), co-morbidities, SABA and ICS containers removed in 2018, AsthmaControlTest, InhalerAdherenceTest, critical errors in inhalers and AsthmaKnowledgeQuestionnaire.Intervention: Patients in the intervention group will receive a personalized educational intervention in our health center. It will consist of 2 consecutive visits over a period of 3 months, we will include information about asthma and its treatment, a personalized self-management plan and training on the use of inhalers. On the second visit, basic educational aspects will be reinforced and re-emphasize the importance of using maintenance medication. Patients in the control group will receive usual care.Statistical Analysis: A descriptive analysis will be carried out in relation to the different variables, calculating means and standard deviations. We will adjust the results with logistic regression. The dependent variable will be analyzed with chi-squared. A p-value<0.05 will be considered statistically significant using SPSS.Limitations: Clinical coding errors and non-reflected pharmaceutical dispensing.4* ConclusionIt is possible that a minimal educational intervention in primary care in asthmatic patients who use high doses of SABA aimed at optimizing their treatment and improving the control of their disease is effective. Declaration of Interest The authors declare no conflict of interest. References and Clinical Trial Registry Information