Telephone-based environmental control interventions in asthmatic patients: what are patients willing to do?

Environmental control education is recommended for allergic patients with persistent asthma, but patients may not be willing to comply with recommendations. In a prior study from our group, only 24% of patients reported making any recommended environmental changes.

To determine what environmental changes allergic asthmatic patients say they would be willing to make and what changes they actually make.

Asthmatic patients with known perennial aeroallergen sensitization were asked by telephone to rate on a 1- to 5-point Likert scale their willingness to make specific environmental changes. Items with mean scores of 3 or higher were used to formulate a practical set of recommendations to be given to patients in stage 2 of the study. Stage 2 patients were given the advice formulated in stage 1 and then telephoned 2 months later to see what changes they actually made.

Stage 1 patients (n = 60) were willing to institute 14 of the 18 proposed allergen-specific recommendations. Of 36 stage 2 patients who were allergic to mite, mold, and/or dander, 29 (80.6%) reported that they complied with at least 1 of the recommendations made in this study. Patients who owned their own home were significantly (P < .05) more likely (91.3%) to make at least 1 change than patients who rented their home (63.6%).

Pending additional information, we suggest that environmental control recommendations for mite, mold, and dander emphasize those used in this study because they appear to be practical for a substantial proportion of patients, especially if they own their home.