S46 EFFECTS OF ALLERGEN AND TRIGGER FACTOR AVOIDANCE ADVICE IN PRIMARY CARE ON ASTHMA CONTROL: A RANDOMISED CONTROLLED TRIAL

¹C. A. Bobb, ²T. Ritz, ³G. Rowlands, ⁴C. Griffiths. ¹Starnet Community Health Sciences St Georges Hospital Medical School, London, UK, ²Southern Methodist University, Department of Psychology, Dallas, USA, ³Institute of Primary Care and Public Health, London South Bank University, London, UK, ⁴MRC Asthma UK Centre in Allergic Mechanisms of Asthma, Centre for Health Sciences, Barts and the London School of Medicine and Dentistry, London, UK

Background Allergy contributes significantly to asthma exacerbation, yet avoidance of allergic triggers is rarely addressed in detail in regular asthma review in primary care.

Objective To determine whether structured, individually tailored allergen and trigger avoidance advice, given as part of a primary care asthma review, improves lung function and asthma control.

Methods In a randomised controlled trial 214 adults with asthma in six general practices were offered either usual care during a primary care asthma review or usual care with additional allergen and trigger identification (by skin prick testing and structured allergy assessment) and avoidance advice according to a standardised protocol by trained practice nurses. Main outcome measures were lung function, asthma control and asthma self-efficacy.

Results Both intervention groups were equivalent in demographic and asthma-related variables at baseline. At 3-month follow-up, patients receiving the allergen and trigger avoidance review showed significant improvements in lung function (assessed by blinded research nurses) compared with those receiving usual care. Adjusted post-treatment means: forced expiratory volume in 1 s (FEV₁) intervention 2.58 litres (2.52–2.63) vs control 2.44 (2.38–2.50) p<0.01; lung age 58.8 years (56.6–60.6) vs 62.0 (59.8–64.3) p<0.05, respectively. No significant differences were found in self-report measures of asthma control. Asthma-specific self-efficacy improved in both groups but did not differ between groups.

Conclusion Allergen and trigger identification and avoidance advice, …