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Abstract: Objectives: To improve the asthma control and adherence to asthma preventer medication of older people using the Patient Asthma Concerns Tool (PACT) to identify and address unmet needs and patient concerns. Methods: Community dwelling adults over 55 years, living in Victoria or New South Wales were recruited into a single-blind, parallel design, randomised-controlled trial comparing person-centred education including device technique, versus written information-only education. Fifty-eight participants randomised to the intervention group and 56 to the control completed participation. Outcome measures: asthma control, adherence to preventer medication, asthma related quality of life, asthma exacerbations and written action plan ownership were assessed at baseline, and 3 and 12 months post intervention. Results: Intervention participants experienced improvements in asthma control, adherence to asthma preventer medication, reduced exacerbations, improved quality of life and an increase in asthma action plan ownership at 3 and 12 months. Conclusion: Asthma outcomes in older people can be significantly improved by delivering tailored education that identifies specific patient concerns and unmet needs. Practical implications: Use of the PACT to identify patient concerns and unmet needs will assist health professionals to improve the health literacy of patients by addressing gaps in their knowledge and perceptions of asthma control. [Copyright &y& Elsevier]

Introduction. Asthma in older people is a major cause of disease burden in Australia and is projected to increase over the next two decades. Current guidelines for asthma care rely predominantly on studies from younger populations. Methods. We undertook a cross-sectional survey of older people with asthma to identify their concerns and their perceived asthma symptom burden. One hundred and ninety-nine people over 55 years of age with asthma were recruited from community pharmacies, in the states of Victoria and NSW, Australia. Results. One-hundred and twenty (62%) participants reported "perfectly" or "very well controlled" asthma over the past month, and 78% claimed adherence to asthma treatment. Despite this, 105 (55%) reported experiencing moderate to severe symptoms and 58 (30%) moderate to extreme restrictions on their lifestyle in the past month. Exacerbations were also common with over one-third of participants seeking emergency asthma care or requiring oral corticosteroids in the past 12 months. In spite of 80% of participants reporting confidence of how to manage their asthma properly, only 10% said they would call an ambulance or visit an Emergency Department if their asthma was "out of control." Further asthma self-management education was considered desirable by two-thirds. However, those over 65 years preferred less autonomy in decision-making compared to those under 65 years. Conclusion. Older people with asthma experience a high symptom burden. A simplified version of our questionnaire could assist GPs, specialists, and asthma educators to identify the individual needs of older patients and to tailor their delivery of asthma care accordingly. [ABSTRACT FROM AUTHOR]