Comprehensive use of environmental control practices among adults with asthma

Asthma is a common chronic illness among adults. National guidelines recommend comprehensive implementation of environmental control practices (ECP) for asthma management. The purpose of this study was to examine the association between preventive asthma care and comprehensive ECP use among adults with asthma. We used data from the Four-State National Asthma Survey, including 3727 adults with asthma. Comprehensive management was defined as implementing at least five of eight ECP: (1) air filter, (2) dehumidifier, (3) mattress cover, (4) pillow cover, (5) no pets, (6) no smoking, (7) no carpets, and (8) washing sheets in hot water. We examined the association between comprehensive implementation of ECP and receipt of preventive asthma care, as measured by number of routine asthma visits in the prior year and physician advice to modify the environment. Overall, 13.3% (95% confidence interval [CI], 11.8-14.8%) of participants reported comprehensive ECP use. The most frequently implemented ECP were no smoking (80%), no pets (54%), and washing sheets in hot water (43%). Comprehensive ECP use was associated with having received physician advice (odds ratio [OR], 2.3; 95% CI, 1.6-3.4) and increased number of routine asthma visits (1-2 visits: OR, 2.4, and 95% CI, 1.5-4.0; 3-4 visits: OR, 2.4, and 95% CI, 1.3-4.5; 5 or more visits: OR, 3.4, and 95% CI, 1.9-6.4). Receipt of preventive asthma care is associated with comprehensive implementation of ECP. Further research is needed to determine the factors mediating these associations to develop more effective asthma counseling.