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Allergen and trigger-avoidance advice helps improve lung function

By Jeremy Cockerill | December 17, 2009

Source: MedWire News

Allergen and trigger-avoidance advice given as part of a primary care asthma review is associated with improved lung function but has little effect on asthma control, study results show.

“National guidelines emphasize the need to address the allergic components of care, and people with asthma rate advice about allergy and allergen avoidance as one of their highest priorities,” explain Thomas Ritz (Southern Methodist University, Dallas, Texas, USA) and team.

To investigate the effects of structured, individually tailored allergen and trigger avoidance advice on patients’ lung function and asthma control, the researchers studied 214 asthmatic adults, aged between 18 and 65 years, from six general practices in south London, UK.

The participants were randomly assigned to receive usual care only or allergen and trigger identification and avoidance advice delivered by trained practice nurses as part of an asthma review.

Both groups were similar in terms of demographics and asthma-related variables at baseline.

The researchers found that after an average follow-up period of 4 months, patients assigned to receive allergen and trigger avoidance advice showed significantly greater improvements in lung function compared with those assigned to usual care. Indeed, 24.1% of patients in the intervention group experienced increases of at least 12% in FEV1 compared with just 9.6% of those assigned to usual care.

However, there were no significant differences between the two groups at follow-up regarding scores on the Asthma Control Questionnaire, an 11-item measure of patients’ perception of how well they are able to control and manage their asthma, or the Asthma Self-Efficacy Scale, a 20-item scale measuring patients’ confidence and feeling of mastery in the management of their illness.

Ritz and team conclude in the journal Clinical and Experimental Allergy: “Our study showed that structured assessment of allergens and triggers and avoidance advice provided by a trained practice nurse in a primary care asthma review resulted in clinically important improvements in lung function 4 months later, while perceived symptoms and disease control were unaffected.”

They add that if the findings are confirmed by further research “there would be a strong case for incorporating this activity into routine primary care asthma reviews.”