Quiana Spears is one of millions of Americans suffering with asthma each year. Spears was a regular at Houston-area hospitals when severe and debilitating bouts of asthma hit her. At times, her condition got so bad she would go to the emergency room up to five times a week. That all dramatically changed thanks to her participation in a study aimed at helping asthmatics like her control and manage their condition and live better.
Baylor College of Medicine, in collaboration with Harris Health System, is spearheading a study to help African-American asthmatic sufferers. The Patient-Centered Outcomes Research Institute (PCORI), a non-governmental institute created as part of the Affordable Care Act, is funding the $2.3 million study. "It's not fun to be drowning in your own fluids," Spears says of her life-long battle to control her asthma. "I know what to do now, and it feels good to know what I'm doing is helping me."
‘African-American adults comprise about 19 percent of the population in Houston, but account for roughly 34 percent of hospital admissions for asthma.’
For Winifred Hamilton, PhD, a researcher at Harris Health System, associate professor, Medicine, Baylor College of Medicine, and the study's principal investigator, seeing Spears' turnaround is exactly why the study is so important. In Houston, African-American adults comprise about 19 percent of the population, but account for roughly 34 percent of hospital admissions for asthma; they are also roughly three times more likely to die from asthma than other adult asthmatics.
As part of the study, participants receive a comprehensive home assessment that looks at environmental factors likely to trigger asthma attacks, a customized exposure reduction and asthma self-management program and on-going support from the research team. "We find time and again that patients who have had asthma for more than 20 years didn't realize certain types of exposures, such as fragrances, affect their condition," Hamilton says. "Sometimes, for example, a study participant will tell us that perfume is a major trigger for them, and then we visit their home and find that every room in the house has a plug-in deodorizer in an outlet spewing chemicals and fragrance into the home. We can help them make the connection and work together to find safer alternatives."
Spears now knows most of her asthma triggers and how to prevent attacks. She uses treatments quickly to lessen attacks and avoid trips to the emergency room. As a result, she rarely goes to hospitals anymore. She knows how Houston's heat, humidity and air quality affect her, and how changing bed linens twice weekly and reducing dust in her home can keep her breathing well. "Most people spend roughly 90 percent of their lives indoors, so reducing indoor pollution is a critical component for good health," Hamilton says. "Among older asthmatics who are retired, no longer working or have mobility and other issues, even more time is spent indoors and in their home. So it's especially important that homes are safe areas that don't affect their asthma."
Other research has shown that reducing exposure to environmental factors like mold, chemical fumes, car exhaust, dust mites and cigarette smoke can significantly reduce asthma symptoms. "I know if I go outdoors, I need to change clothes when I go back inside the house to keep pollen and other pollution out," Spears says. "I even have to ask smokers who visit me to have a change of clothes or make sure they don't smoke before they visit. It's for my health, but I leave it up to them if they want to see me."
While results from the study are not yet known, several participants like Spears report success at controlling and managing their condition. Many are able to resume active lives. The study is beginning its third year and still enrolling participants. To qualify, individuals must be 18 years or older, African American, have poorly controlled asthma, live in Harris County and not plan to move within a year. Studies similar to this have shown that for every $1 spent on a home-based intervention to reduce asthma triggers and improve asthma care, there's a savings of $5-$14 in avoided healthcare costs or productivity losses.