Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore

Grant Torie L.; McCormack Meredith C.; Peng Roger D.Keet Corinne A.Rule Ana M.Davis Meghan F.Newman MichelleBalcer-Whaley SusanMatsui Elizabeth C.

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Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore

机译：Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore

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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.

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来源
《The journal of asthma》 |2023年第3期|625-634|共10页
作者
Grant Torie L.; McCormack Meredith C.; Peng Roger D.Keet Corinne A.Rule Ana M.Davis Meghan F.Newman MichelleBalcer-Whaley SusanMatsui Elizabeth C.;
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作者单位

Johns Hopkins University,Johns Hopkins Univ;

Sch Med,Johns Hopkins Univ;

Dept Biostat,Johns Hopkins Bloomberg Sch Publ HlthDept Environm Hlth & Engn,Johns Hopkins Bloomberg Sch Publ Hlth;

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正文语种英语
中图分类呼吸系及胸部疾病;
关键词
Urban asthma; indoor exposures; environmental control; pediatric asthma; EXHALED NITRIC-OXIDE; ASTHMA MORBIDITY; MOUSE ALLERGEN; COCKROACH ALLERGEN; AIR-POLLUTION; EXPOSURE; SENSITIZATION; ASSOCIATION; ADOLESCENTS; MANAGEMENT;

Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore

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