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Economic Value of Home-Based, Multi-Trigger, Multicomponent Interventions with an Environmental Focus for Reducing Asthma Morbidity

Authors :
Stella Kinyota
Briana Lawrence
Jill M. Ferdinands
Elizabeth J. Herman
Theresa Ann Sipe
Colin B. Ligon
David S. P. Hopkins
Deidre D. Crocker
Gema G. Dumitru
Source :
American Journal of Preventive Medicine. 41:S33-S47
Publication Year :
2011
Publisher :
Elsevier BV, 2011.

Abstract

Context: Asthma exacerbations are commonly triggered by exposure to allergens and irritants within the home. The purpose of this review was to evaluate evidence that interventions that target reducing these triggers through home visits may be beneficial in improving asthma outcomes. The interventions involve home visits by trained personnel to conduct two or more components that address asthma triggers in the home. Intervention components focus on reducing exposures to a range of asthma triggers (allergens and irritants) through environmental assessment, education, and remediation. Evidence acquisition: Using methods previously developed for the Guide to Community Preventive Services, a systematic review was conducted to evaluate the evidence on effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus to improve asthma-related morbidity outcomes. The literature search identified over 10,800 cita- tions. Of these, 23 studies met intervention and quality criteria for inclusion in the final analysis. Evidence synthesis: In the 20 studies targeting children and adolescents, the number of days with asthma symptoms (symptom-days) was reduced by 0.8 days per 2 weeks, which is equivalent to 21.0 symptom-days per year (range of values: reduction of 0.6 to 2.3 days per year); school days missed were reduced by 12.3 days per year (range of values: reduction of 3.4 to 31.2 days per year); and the number of asthma acute care visits were reduced by 0.57 visits per year (interquartile interval: reduction of 0.33 to 1.71 visits per year). Only three studies reported outcomes among adults with asthma, finding inconsistent results. Conclusions: Home-based, multi-trigger, multicomponent interventions with an environmental focus are effective in improving overall quality of life and productivity in children and adolescents with asthma. The effectiveness of these interventions in adults is inconclusive due to the small number of studies and inconsistent results. Additional studies are needed to (1) evaluate the effectiveness of these interventions in adults and (2) determine the individual contributions of the various intervention components.

Details

ISSN :
07493797
Volume :
41
Database :
OpenAIRE
Journal :
American Journal of Preventive Medicine
Accession number :
edsair.doi...........76c936f71e3527c206e8ca1d409cfe00
Full Text :
https://doi.org/10.1016/j.amepre.2011.05.011