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

Br J Gen Pract. 2007 Mar;57(536):184-90.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Animals
  • Asthma / drug therapy
  • Asthma / prevention & control*
  • Bedding and Linens / parasitology
  • Bedding and Linens / standards
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Peak Expiratory Flow Rate
  • Prospective Studies
  • Pyroglyphidae*
  • Self Administration
  • Tick Control / methods*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones