title: Impact of Adding a Decision Aid to Patient Education in Adults with Asthma: A Randomized Clinical Trial.
abstract: BACKGROUND
  Not providing adequate patient education interventions to asthma patients remains a major care gap. To help asthma patients and caregivers discuss inhaled controller medication use, our team has previously developed a decision aid (DA). We sought to assess whether adding this DA to education interventions improved knowledge, decisional conflict, and asthma control among adults with asthma.
  
  
  METHODS
  A parallel clinical trial (NCT02516449). We recruited adults with asthma, aged 18 to 65 years, prescribed inhaled controller medication to optimize asthma control. Educators randomly allocated participants either to the education + DA or to the education group. At baseline and two-month follow-up, we measured asthma knowledge (primary outcome) with a validated self-administered questionnaire (score -37 to +37). Secondary outcomes included decisional conflict and asthma control. Blinded assessors collected data. Between the two time points, the within- and between-group changes were estimated by generalized linear mixed models.
  
  
  RESULTS
  Fifty-one participants (response rate: 53%; age: 44 ± 13 years; women: n = 32) were randomized either to the education + DA group (n = 26) or to the education group (n = 25), and included in statistical analyses. Between baseline and follow-up, mean [95% CI] knowledge scores increased from 21.5 [19.9-23.2] to 25.1 [23.1-27.0] in the education + DA group (P = 0.0002) and from 24.0 [22.3-25.7] to 26.0 [24.0-28.0] in the education group (P = 0.0298). In both of the groups, decisional conflict and asthma control improved. There were no differences between groups.
  
  
  CONCLUSIONS
  Education improved knowledge, decisional conflict, and asthma control whether the DA was added or not.
authors.affiliation: Knowledge Translation, Education and Prevention Chair in Respiratory and Cardiovascular Health, Laval University, Quebec City, QC, Canada.|Quebec Heart and Lung Institute-Laval University, Quebec City, QC, Canada.
authors.forename: Myriam E
authors.identifier: http://orcid.org/0000-0002-0559-5731
authors.initials: ME
authors.lastname: Gagné
authors.affiliation: Canada Research Chair in Implementation of Shared Decision Making in Primary Care, Laval University, Quebec City, QC, Canada.|CHU de Quebec Research Center, Population Health and Optimal Health Practices Research Unit, Quebec City, QC, Canada.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.affiliation: CHU de Quebec Research Center, Population Health and Optimal Health Practices Research Unit, Quebec City, QC, Canada.|Chair on Adherence to Treatments, Laval University, Quebec City, QC, Canada.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Moisan
authors.affiliation: Knowledge Translation, Education and Prevention Chair in Respiratory and Cardiovascular Health, Laval University, Quebec City, QC, Canada.|Quebec Heart and Lung Institute-Laval University, Quebec City, QC, Canada.
authors.forename: Louis-Philippe
authors.initials: LP
authors.lastname: Boulet
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D001249:Asthma / Q000517:prevention & control*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*
chemical_list: D001993:Bronchodilator Agents