TY - JOUR
T1 - Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore
AU - Grant, Torie L.
AU - McCormack, Meredith C.
AU - Peng, Roger D.
AU - Keet, Corinne
AU - Rule, Ana M.
AU - Davis, Meghan F.
AU - Newman, Michelle
AU - Balcer-Whaley, Susan
AU - Matsui, Elizabeth C.
N1 - Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2023
Y1 - 2023
N2 - Objective: To determine if the addition of home environmental control strategies (ECSs) to controller medication titration reduces asthma controller medication requirements and in-home allergen concentrations among children with persistent asthma in Baltimore City. Methods: 155 children ages 5–17 with allergen-sensitized asthma were enrolled in a 6-month randomized clinical trial of multifaceted, individually-tailored ECS plus asthma controller medication titration compared to controller medication titration alone. Participants had to meet criteria for persistent asthma and have had an exacerbation in the previous 18 months. Allergen sensitization (mouse, cockroach, cat, dog, dust mite) was assessed at baseline and home dust allergen concentrations were measured at baseline, 3 and 6 months. ECS was delivered 3–4 times over the trial. Asthma controller medication was titrated using a guidelines-based algorithm at baseline, 2, 4, and 6 months. The primary outcome was controller medication treatment step at 6 months (0–6, as-needed albuterol to high-dose ICS + LABA). Results: The population was predominately Black (90%), on public insurance (93%), and male (61%). The mean age was 10.1 years (SD 3.3). More than 70% were sensitized to a rodent, >50% to cockroach, and 70% were polysensitized. At 6 months, there were no differences in either treatment step (3.8 [SD 1.4] vs. 3.7 [SD 1.5]) or allergen concentrations between groups. Conclusion: Among this predominantly low-income, Black pediatric asthma population, the addition of ECS to controller medication titration reduced neither indoor allergen concentrations nor controller medication requirements compared to controller medication titration alone.
AB - Objective: To determine if the addition of home environmental control strategies (ECSs) to controller medication titration reduces asthma controller medication requirements and in-home allergen concentrations among children with persistent asthma in Baltimore City. Methods: 155 children ages 5–17 with allergen-sensitized asthma were enrolled in a 6-month randomized clinical trial of multifaceted, individually-tailored ECS plus asthma controller medication titration compared to controller medication titration alone. Participants had to meet criteria for persistent asthma and have had an exacerbation in the previous 18 months. Allergen sensitization (mouse, cockroach, cat, dog, dust mite) was assessed at baseline and home dust allergen concentrations were measured at baseline, 3 and 6 months. ECS was delivered 3–4 times over the trial. Asthma controller medication was titrated using a guidelines-based algorithm at baseline, 2, 4, and 6 months. The primary outcome was controller medication treatment step at 6 months (0–6, as-needed albuterol to high-dose ICS + LABA). Results: The population was predominately Black (90%), on public insurance (93%), and male (61%). The mean age was 10.1 years (SD 3.3). More than 70% were sensitized to a rodent, >50% to cockroach, and 70% were polysensitized. At 6 months, there were no differences in either treatment step (3.8 [SD 1.4] vs. 3.7 [SD 1.5]) or allergen concentrations between groups. Conclusion: Among this predominantly low-income, Black pediatric asthma population, the addition of ECS to controller medication titration reduced neither indoor allergen concentrations nor controller medication requirements compared to controller medication titration alone.
KW - Urban asthma
KW - environmental control
KW - indoor exposures
KW - pediatric asthma
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U2 - 10.1080/02770903.2022.2083634
DO - 10.1080/02770903.2022.2083634
M3 - Article
C2 - 35657971
AN - SCOPUS:85131520388
SN - 0277-0903
VL - 60
SP - 625
EP - 634
JO - Journal of Asthma
JF - Journal of Asthma
IS - 3
ER -