Patient Empowered Strategy to Reduce Asthma Morbidity in Highly Impacted Populations (PESRAMHIP), United States, 2017-2021

Black and Latinx patients bear a disproportionate burden of asthma. Efforts to reduce the disproportionate morbidity have been mostly unsuccessful, and guideline recommendations have not been based on studies in these populations. PREPARE (PESRAMHIP) is a pragmatic, open-label trial of 1201 randomly assigned African American/Black and Hispanic/Latinx adults with moderate-to-severe asthma to use a patient-activated, reliever-triggered inhaled corticosteroid strategy (PARTICS) plus usual care (intervention) or to continue usual care. Participants had one in-person visit to consent, randomize and collect baseline data followed by 15 monthly questionnaires. The primary end point of this study was the annualized rate of severe asthma exacerbations. Secondary end points included monthly asthma control as measured with the Asthma Control Test (ACT; range, 5 [poor] to 25 [complete control]), quality of life as measured with the Asthma Symptom Utility Index (ASUI; range, 0 to 1, with lower scores indicating greater impairment), and participant-reported missed days of work, school, or usual activities. Safety was also assessed.