Treating Asthma More Effectively, With Strong Results for Black and Latino Adults
Published: August 27, 2026
A new study reveals that people with asthma tend to see better outcomes when they use a controller medicine along with quick-relief inhaler to treat symptoms.
At a Glance: Treating Asthma More Effectively
- A better way to treat severe asthma. The PREPARE study found that using a controller inhaler together with a quick-relief inhaler when asthma symptoms start can help people with moderate to severe asthma have fewer asthma attacks and better asthma control.
- Strong results for Black and Latino adults. The PREPARE study looked at Black and Latino adults who were more likely to have moderate to severe asthma. This group is more likely to visit the ER and miss work or school because of asthma. The study showed that using a controller inhaler with a quick-relief inhaler worked well for Black and Latino adults.
- Fewer attacks, better daily life. People using this treatment had 15% fewer severe asthma attacks, better asthma control and improved quality of life than people who received usual care. They had fewer missed days of work, school, and daily activities.
- Two inhalers can work together. The study found that taking a daily controller inhaler and using it again with a quick-relief inhaler or nebulizer during asthma symptoms helped reduce severe attacks more than usual asthma care.
- Talk with your healthcare provider. If you have moderate to severe asthma, ask your healthcare provider if this treatment approach could help you better control your asthma.
A new study revealed that people with asthma had better outcomes when they used a controller medicine along with a quick-relief inhaler to treat symptoms, compared with those who continued their usual care.
The benefits of this treatment approach are especially helpful for Black and Latino adults, who tend to have a higher risk of asthma attacks.
The findings were part of the PREPARE (Person Empowered Asthma Relief) study. PREPARE found the treatment approach led to better asthma outcomes for Black and Latino adults with moderate to severe asthma.
The research was funded by the Patient-Centered Outcomes Research Institute (PCORI). It was led by Elliot Israel, MD, of Brigham and Women’s Hospital and Harvard Medical School.
Allergy & Asthma Network served on the Patient Advisory Committee and helped recruit patients for the PREPARE Study.
What is the PREPARE Asthma Study?
About 28 million people in the United States have asthma. Black and Latino people are more likely to get very sick from asthma than other groups. Studies have shown that Black and Latino people are more likely to go to the ER or urgent care, stay in the hospital, and miss work or school due to their asthma. They may have a harder time getting the asthma care and treatment they need.
Why is this? There are many reasons, from more insurance barriers to greater exposure to air pollution, mold, pollen, dust mites, cockroaches, and other asthma triggers or allergens.
In standard asthma treatment, most people receive two inhalers. One is an inhaled corticosteroid (ICS). It is taken 1-2 times per day to reduce airway inflammation and symptoms like coughing and wheezing. This helps keep asthma under control over time. The second is a quick-relief albuterol inhaler to use when asthma symptoms occur. (The quick relief medicine can also be taken with a nebulizer. This is a machine that turns the medicine into a mist.)
Could combining the ICS with the quick-reliever inhaler approach help people with asthma in Black and Latino communities? The PREPARE Study aimed to find out.
Researchers studied this combined approach in 1,201 Black and Latino adults. All of them had moderate to severe asthma. In the study, the adults:
- Took their ICS inhaler and their quick-relief albuterol inhaler or nebulizer when symptoms occurred; and
- Did not change their usual asthma medication and management routine.
This combined approach is called PARTICS, or Patient-Activated Reliever-Triggered Inhaled Corticosteroid.
Previous studies have shown that people who used a controller medicine with a quick-reliever for asthma symptoms had fewer asthma attacks. But these studies did not include many Black and Latino people. They also did not include people who used a nebulizer for quick asthma relief.
In the PREPARE study, one group used PARTICS: a controller inhaler along with a quick-relief inhaler or nebulizer when they had asthma symptoms. They watched videos about asthma and how to take the two medicines. The other group continued with their usual asthma care.
What are Key Findings of the Study for Patients and Caregivers?
After 15 months, researchers compared the two groups to see if the combined therapy could help prevent asthma attacks.
The study found that the combined approach:
- Led to fewer asthma attacks in Black and Latino adults with moderate to severe asthma.
- Helped people control their asthma better and feel better overall.
- Meant less time away from work or school.
- Let people take part in more activities.
What are Key Findings of the Study for Healthcare Professionals?
Researchers found that people who used the combined treatment had 15% fewer severe asthma attacks than people who received usual care. Severe attacks were identified as those that led to prescriptions for corticosteroid pills or a hospital stay.
People using the combined treatment also had better asthma control. They had higher scores on the Asthma Control Test (ACT) and Asthma Symptom Utility Index (ASUI). They also showed higher quality-of-life scores. In addition, they needed less healthcare for asthma, such as doctor visits or emergency care.
Study Results: Combined treatment vs. Usual Care
- Fewer asthma attacks. People who used the combined treatment had almost 1 fewer attack per year than those who used usual care.
- Better asthma control. People in the combined treatment group saw their asthma control score go up by 3.4 points. This is a meaningful change in asthma control. The usual care group only went up by 2.5 points.
- Better quality of life. The Asthma Symptom Utility Index was used to measure quality of life. An increase in quality-of-life score was seen in the group who used the combined treatment.
- Few missed days at school or work or doing usual activities. People in the combined treatment group missed 3.4 fewer days than the usual care group.
| Study Metric | ICS & Quick Reliever Group (PARTICS) | Usual Care Group |
|---|---|---|
| Rate of asthma attacks per year | 0.69 | 0.82 |
| Asthma control scores | 3.4 increase | 2.5 increase |
| Quality of life scores | 0.12 increase | 0.08 increase |
| Days missed – work, school, activities | 13.4 days | 16.8 days |
Key takeaway: the PARTICS group reported 13 fewer asthma attacks per 100 patients per year, compared to the usual care group.
The PREPARE study findings support the role of a combined ICS-quick reliever approach for those with uncontrolled asthma. It’s particularly helpful to Black and Latino patients and other groups affected by asthma disparities.
What do Asthma Guidelines Recommend?
National and global asthma treatment guidelines recommend the use of 2-in-1 inhalers with two medications. This 2-in-1 approach is slightly different from the approach in the PREPARE study.
One combines ICS, such as budesonide, and formoterol, a fast- and long-acting bronchodilator, often used with a spacer for better delivery. It reduces airway inflammation and helps open airways quickly. The inhaler is used once daily to prevent symptoms and when symptoms flare or during acute flare-ups. This is known as Single Maintenance and Reliever Therapy (SMART)
Another 2-in-1 inhaler combines ICS and albuterol, but it is only used for quick relief. Patients still use a daily controller inhaler along with it.
The 2-in-1 inhalers can include either a metered dose inhaler or dry powder inhalers. They aim to help simplify asthma care and overall asthma management. The 2-in-1 inhalers can help reduce confusion about which inhaler to use and when.
What do Patients and Caregivers Need to Know
If you have moderate to severe asthma, talk with your healthcare provider about adding a controller medicine to your quick-relief treatment.
Questions to ask include:
- Is my asthma considered moderate to severe?
- Am I a good candidate for using a controller medicine along with my quick-relief inhaler?
- What are the benefits of this approach?
- Should I use the controller inhaler every day, when symptoms start, or both?
- Would using a 2-in-1 inhaler help my asthma?
- How would this treatment fit in with my Asthma Action Plan?
The bottom line is that more effective and efficient asthma treatment options, alongside prevention measures like vaccinations, are available for patients to include in their treatment plan.
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Supported by the Patient-Centered Outcomes Research Institute (PCORI).
August 2026
Reviewed by:
Elliot Israel, MD, is the director of the Respiratory Therapy Department, the director of clinical research in the Pulmonary and Critical Care Medicine Division, and the Gloria M. and Anthony C. Simboli Distinguished Chair in Asthma Research at Brigham and Women’s Hospital in Boston. He is also a professor of medicine at Harvard Medical School. Dr. Israel received his medical degree from the Johns Hopkins University School of Medicine.
