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A randomized controlled study on the effectiveness of a multifaceted intervention program in the primary prevention

M Chan-Yeung1, J Manfreda, H Dimich-Ward

  • 1Department of Medicine, University of British Columbia, Vancouver.

Archives of Pediatrics & Adolescent Medicine
|July 13, 2000
PubMed

Insights

A multifaceted intervention program modestly reduced the risk of asthma and allergic rhinitis in high-risk infants by 12 months of age. Further studies are needed to confirm long-term effectiveness in primary asthma prevention.

Area of Science:

  • Pediatrics
  • Allergy and Immunology
  • Preventive Medicine

Background:

  • Asthma prevalence has risen significantly in developed nations over the last two decades.
  • The efficacy of interventions for the primary prevention of asthma remains under-investigated.

Purpose of the Study:

  • To evaluate a comprehensive intervention strategy for the primary prevention of asthma in infants identified as high-risk.
  • The study focused on infants from birth to 1 year of age.

Main Methods:

  • A prospective, randomized, controlled trial was conducted with prenatal randomization.
  • The study involved 545 high-risk infants across two Canadian university hospital settings.
  • Interventions included allergen avoidance (dust mites, pets, smoke), promotion of breastfeeding, and partially hydrolyzed formula supplementation.

Main Results:

  • The intervention group showed a reduced risk of probable or possible asthma (adjusted relative risk: 0.66) and allergic rhinitis without colds (adjusted relative risk: 0.51) at 12 months.
  • No significant difference was observed in the incidence of positive skin test results for common inhalant allergens between groups.

Conclusions:

  • The multifaceted intervention demonstrated a statistically significant, albeit modest, reduction in asthma and allergic rhinitis risk in high-risk infants by age one.
  • Long-term follow-up studies are recommended to ascertain the intervention's definitive role in primary asthma prevention due to the lack of a validated asthma definition at 12 months.
Abstract

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