Home-Based Environmental Control Intervention Not Effective in Pediatric Asthma

Children with poorly controlled asthma who underwent a home-based environmental control intervention had the same risk for repeat emergency department visits as children who did not receive the intervention, according to the results of a study published in Pediatric Pulmonology.

Inner-city children with frequent asthma emergency department visits were randomly assigned to either a home-based environmental control intervention or a control group. Allergen-specific immunoglobulin E serologic and secondhand smoke exposure biomarker testing was performed in all children and used to inform the environmental control intervention. The rate of emergency department visits was compared between groups at the 12-month follow-up.

Of the 222 children who met inclusion criteria and were enrolled as study participants, 107 were randomly assigned to the environmental control intervention and 115 to the control group. Allergic sensitization was prominent, with 83% of the children testing positive to ≥1 allergens, and more than half the children tested positive for secondhand smoke exposure. In the primary study outcome, there was no difference in increased risk for repeat emergency department visits at 12 months between the groups.

The researchers wrote, “This study indicates that a home-based targeted [environmental control] intervention was not effective in reducing repeat asthma [emergency department] visits in children with persistent asthma when compared to a control group who received less intensive [environmental control] home based intervention.”

However, the researchers still had hope for the intervention, adding, “The intensity of the [environmental control] component of the intervention was likely insufficient when compared to the prior effective homebased interventions, for example, the Inner-City Asthma Study (ICAS) that provided HEPA air and HEPA vacuum cleaners with ongoing integrated pest management services.”

Reference

Manns Butz A, Bollinger M, Ogborn J, et al. Children with poorly controlled asthma: randomized controlled trial of a home-based environmental control intervention [published January 6, 2019]. Pediatr Pulmonol. doi:10.1002/ppul.24239