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Randomized Controlled Trial
. 2007 Mar;57(536):184-90.

House dust mite allergen avoidance and self-management in allergic patients with asthma: randomised controlled trial

Marjolein P de Vries  1 , Lisette van den Bemt, Karen Aretz, Bart P A Thoonen, Jean W M Muris, Arnold D M Kester, Sonja Cloosterman, C P Onno van Schayck
Affiliations
Randomized Controlled Trial

House dust mite allergen avoidance and self-management in allergic patients with asthma: randomised controlled trial

Marjolein P de Vries et al. Br J Gen Pract. 2007 Mar.

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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Figures

Figure 1
Figure 1
Patient flow for selection, inclusion and study stages.
Figure 2
Figure 2
Inhaled corticosteroids use during the study.
See this image and copyright information in PMC

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