Study

Individualizing Treatment of Asthma in Primary Care (iTREAT-PC)

This is a research study to compare the safety and effectiveness of two different ways to treat asthma. The first way is adding inhaled corticosteroids to your rescue medication (the medicine that opens your airways quickly). The second way is using an antibiotic (azithromycin) over time. These treatments will be used alone or together and compared to usual care. Everyone in the study will have a system to track asthma symptoms at home. We hope to find out who will do best with each type of treatment, which is not known at this time. The long-term goal of the study is to find the best ways to decrease the number of asthma attacks people have, to improve their day-to-day symptoms, and improve their quality of life. By comparing these guideline-approved treatments, the study also evaluates which approaches best reduce the need for emergency care or hospital visits and help patients avoid missed days of school or work.

Why this Research Matters

Patients need new ways to avoid asthma attacks, and this research study evaluates which guideline-approved treatments work best for different individuals. If you choose to take part, participation lasts for 16 months. Every two months, you will be asked to complete a short survey (less than 10 minutes) online or by phone regarding your asthma symptoms and medication use. You may also be invited to complete an optional blood draw and a brief interview about your experience. Participants are compensated for their time and effort via gift cards for completing the enrollment process and follow-up surveys. Individuals ages 18 and older may complete a self-directed online eligibility and consent process at their convenience.

Who can Participate

Adult

You may qualify for this study if you: -Are between 13 and 75 years of age -Have a clinical asthma diagnosis for at least one year -Currently have a prescription for a daily inhaled corticosteroid (ICS) -Have either had an asthma flare-up (attack) in the past year OR your asthma is not well controlled (ACT score less than 20) -Are able to provide consent (or assent for teenagers) in English or Spanish Inclusion Criteria: Clinical asthma diagnosis for a minimum of 1 year; between 13 and 75 years of age; active prescription for an inhaled corticosteroid for at least one month; ACT score < 20 or a major exacerbation in the past 12 months. NOTE: Patients with COPD may be eligible if they are never-smokers or have normal diffusing capacity (DLCO). Exclusion Criteria: Another household member already enrolled; taking daily or every-other-day oral steroids; allergy to macrolides (e.g., azithromycin); history of certain liver or heart rhythm conditions (prolonged QT interval); or diagnosis of other significant lung diseases like cystic fibrosis or bronchiectasis. Self-Directed Process: Individuals ages 18 and over may complete an asynchronous, self-directed online eligibility and consent process here: https://redcap.ucdenver.edu/surveys/?s=AY833KYEY7L7TL3X. All participants must meet with study staff to confirm eligibility and finalize consent before randomization.