Effect of home environment control on children with atopic or non-atopic asthma.

BACKGROUND Although allergen avoidance is known to be important for treating atopic diseases, there is a very limited amount of time for clinical education of patients on this topic. METHODS We compared the effect of the thorough home visit counseling (>60 minutes per visit) for avoiding house dust mites (HDMs) with that of regular guidance in our clinics (10 minutes per patient). We enrolled 36 children with asthma (7 years of age or younger; mean, 3.8) in this study under an informed consent. After enrolling the 24 patients for the home visit, 12 families were enrolled as controls for the regular clinical guidance. Between June 1995 and June 1996, we visited the homes of 24 children with asthma enrolled in this study every month and performed a thorough HDM-avoidance counseling of more than 60 minutes (home visit counsel) at each visit. We compared the effects of this counseling with those of the regular clinical guidance given (10 minutes per patient) to the remaining 12 children with asthma. We also evaluated the effect of home visit counseling on children of two subgroups, i.e., an atopic (with positive IgE antibody against HDM) and a non-atopic (without detectable IgE antibodies against 8 common allergens) subgroup. RESULTS Home visit counseling markedly reduced the frequencies of asthma attacks (p < 0.000001), the required theophylline dosages (p < 0.0005), and the levels of HDM allergens (p < 0.0005) in the atopic subgroups, whereas the effect of regular counseling on these 3 items was relatively less (p < 0.05 or not significant). Surprisingly, home visit counseling also markedly reduced the asthma attacks (p < 0.00001) and theophylline dosages (p < 0.00001) of children with non-atopic asthma. CONCLUSIONS These results suggest that thorough allergen avoidance counseling is effective for children with non-atopic asthma as well as atopic asthma.