de Vries MP, van den Bemt L, Aretz K, Thoonen BPA, Muris JWM, Kester ADM, Cloosterman S, van Schayck CPO. House dust mite allergen avoidance and self-management in allergic patients with asthma: randomised controlled trial.
Br J Gen Pract 2007;
57:184-90. [PMID:
17359604 PMCID:
PMC2042544]
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Abstract
BACKGROUND
The efficacy of bed covers that are impermeable to house dust mites has been disputed.
AIM
The aim of the present study was to investigate whether the combination of 'house dust mite impermeable' covers and a self-management plan, based on peak flow values and symptoms, leads to reduced use of inhaled corticosteroids (ICS) than self-management alone.
DESIGN OF STUDY
Prospective, randomised, double blind, placebo-controlled trial.
SETTING
Primary care in a south-eastern region of the Netherlands.
METHOD
Asthma patients aged between 16 and 60 years with a house dust mite allergy requiring ICS were randomised to intervention and placebo groups. They were trained to use a self-management plan based on peak flow and symptoms. After a 3-month training period, the intervention commenced using house dust mite impermeable and placebo bed covers. The follow-up period was 2 years. Primary outcome was the use of ICS; secondary outcomes were peak expiratory flow parameters, asthma control, and symptoms.
RESULTS
One hundred and twenty-six patients started the intervention with house dust mite impermeable or placebo bed covers. After 1 and 2 years, significant differences in allergen exposure were found between the intervention and control groups (P<0.001). No significant difference between the intervention and control groups was found in the dose of ICS (P = 0.08), morning peak flow (P = 0.52), peak flow variability (P = 0.36), dyspnoea (P = 0.46), wheezing (P = 0.77), or coughing (P = 0.41). There was no difference in asthma control between the intervention and control groups.
CONCLUSION
House dust mite impermeable bed covers combined with self-management do not lead to reduced use of ICS compared with self-management alone.
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