Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial

Figures & data

Figure 1 Flowchart of Enrollment, Randomization, and Retention of Participant According to Multi-arm Consort Diagram.

Table 1 Home Management Manual Applied in the Study

Elimination of dust mites^Citation28,Citation29	Cleaning home Use damp towel to clean up all surface of furniture and use damp mop to clean floor. Changing and washing bed and pillow cover in hot water and keep dry completely
Mold^Citation30	Eliminated source of moisture Clean up the mold with soap and water. Always keep all surfaces dry. Make the air ventilation flow by using an exhaust fan or open window when cooking and showing. If there is water leak in your home, fix it.
Cockroaches and Pests^Citation31	Keep counters, sinks, tables, and floors clean and free of clutter. Clean dishes, crumbs, and spills right away. Store food in airtight containers. Seal cracks or openings around or inside cabinets.
Pets^Citation32	Find another home for your cat or dog. Keep pets outside if possible. If you must have a pet inside, keep it out of the bedroom with an asthma patient. Keep pets off your furniture.
Secondhand smoke^Citation33	Do not let anyone smoke near your child. If you smoke, until you can quit, do not smoke in your home or car.
Chemical irritants^Citation34	Make sure your child is not around. Open windows or doors or use an exhaust fan. Always follow the instructions on the product label.
Outdoor air pollution^Citation34	Monitor the Air Quality Index on your local weather report. Know when and where air pollution may be bad. Regular exercising is healthy. Check your local air quality, knowing when to play and when to take it a little easier. Schedule outdoor activities at times when the air quality is better. In the summer, this may be in the morning. Stay inside with the windows closed on high pollen days and when pollutants are high. Use your air conditioner to help filter the air coming into the home. Central air systems are the best. Remove indoor plants if they irritate or cause symptoms for you and your family.

Figure 2 Air filter set-up.

Table 2 General Characteristics of Participants

Characteristics	Frequency (%)			P-value
	Home Management (n = 38)	Air Filter (n = 38)	Control (n = 38)
Sex				0.005
Male	9 (23.7)	23 (60.5)	16 (42.1)
Female	29 (76.3)	15 (39.5)	22 (57.9)
Education level				0.38
Up to secondary school	18 (47.4)	21 (55.3)	24 (63.2)
Higher	20 (52.6)	17 (44.7)	14 (36.8)
Alcohol consumption				0.70
No	26 (68.4)	23 (60.5)	26 (68.4)
Yes	12 (31.6)	15 (39.5)	12 (31.6)
Smoking status				<0.001
No	38 (100.0)	30 (78.9)	25 (65.8)
Yes	0 (0.0)	8 (21.1)	13 (34.2)
Chronic disease				0.47
No	8 (21.1)	8 (21.1)	12 (31.6)
Yes	30 (78.9)	30 (78.9)	26 (68.4)
Medication use				0.013
No	18 (47.4)	28 (73.7)	29 (76.3)
Yes	20 (52.6)	10 (26.3)	9 (23.7)
Family history of asthma				0.038
No	32 (84.2)	22 (57.9)	25 (65.8)
Yes	6 (15.8)	16 (42.1)	13 (34.2)
Allergy				0.48
No	11 (28.9)	16 (42.1)	14 (36.8)
Yes	27 (71.1)	22 (57.9)	24 (63.2)
Characteristics (median, IQR)
Age, years	48.0 (5)	43.0 (15)	46.5 (14)	0.09
Asthma Control Test, score	23.0 (6)	22.5 (6)	21.0 (4)	0.56

Table 3 Change of Asthma Quality of Life at Baseline, Post-Intervention, and Follow-Up

mAQLQ	Median (25–75 Percentile)
	Home Management	P-value^†	Air Filter	P-value^†	Control	P-value^†
Total score
Baseline	89.0 (80.8–96.3)		95.5 (82.3–100.3)		93.0 (84.5–99.0)
Post-intervention	93.0 (80.3–103.0)	0.33	97.0 (90.0–101.3)	0.044	90.5 (77.0–99.0)	0.12
Follow up	95.5 (83.3–104.0)	0.63	94.0 (82.3–101.0)	0.95	93.0 (80.8–99.0)	0.62
Emotion
Baseline	31.5 (26.7; 34.0)		32.0 (31.0; 34.2)		31.0 (26.7; 33.0)
Post-intervention	32.0 (26.5; 34.0)	0.49	31.0 (29.0; 34.0)	0.15	31.0 (26.0; 33.2)	0.50
Follow up	32.0 (28.3; 35.0)	0.68	32.0 (29.0; 34.0)	0.98	31.0 (27.7; 34.2)	0.16
Activity
Baseline	18.0 (16.7; 21.0)		20.0 (16.7; 21.0)		19.0 (17.0; 21.0)
Post-intervention	20.0 (17.0; 21.0)	0.65	21.0 (19.0; 21.0)	0.09	19.0 (17.0; 21.0)	0.38
Follow up	20.5 (17.2; 21.0)	0.95	20.0 (16.7; 21.0)	0.80	19.0 (17.0; 21.0)	0.93
Environmental
Baseline	15.0 (10.7; 16.0)		16.5 (14.0; 19.0)		17.0 (13.0; 19.0)
Post-intervention	17.0 (13.7; 21.0)	0.004	17.0 (16.0; 19.0)	0.20	17.0 (13.0; 19.0)	0.83
Follow up	17.0 (11.7; 21.0)	0.041	17.0 (14.0; 19.0)	0.82	17.0 (12.7; 19.0)	0.78
Symptoms
Baseline	26.0 (23.0; 28.0)		27.0 (20.7; 28.0)		27.5 (23.0; 28.0)
Post-intervention	26.0 (20.0; 27.0)	0.28	28.0 (25.5; 28.0)	0.002	26.0 (21.7; 28.0)	0.12
Follow up	27.0 (23.7; 28.0)	0.79	27.0 (20.7; 28.0)	0.34	27.5 (22.0; 28.0)	0.44

Wassenaar D. Effectiveness of vacuum cleaning and wet cleaning in reducing house-dust mites, fungi and mite allergen in a cotton carpet: a case study. Exp Appl Acarol. 1988;4(1):53–62.

 PubMed Web of Science ®Google Scholar

Gautier C, Charpin D. Environmental triggers and avoidance in the management of asthma. J Asthma Aller. 2017;10:47.

 PubMed Web of Science ®Google Scholar

US Environmental Protection Agency. A brief guide to mold, moisture, and your home. Washington, DC: Office of Air and Radiation Indoor Environments Division. Available from: https://www.epa.gov/sites/production/files/2016-10/documents/moldguide12.pdf. Accessed May 18, 2024.

 Google Scholar

US EPA. Citizen s guide to pest control and pesticide safety; 2005.

 Google Scholar

CDC. Help your child gain control over asthma. https://www.epa.gov/sites/production/files/2013-08/documents/ll_asthma_brochure.pdf. Accessed May 18, 2024.

 Google Scholar

US EPA. Secondhand tobacco smoke and the health of your family. Available from: https://www.epa.gov/sites/production/files/2014-09/documents/trifold_brochure.pdf. Accessed September, 2020.

 Google Scholar

Environmental Potection Agency TU. Asthma Triggers: gain Control. Available from: https://www.epa.gov/asthma/asthma-triggers-gain-control. Accessed September, 2020.

 Google Scholar

Data Sharing Statement

The data that support the findings of this study are available on request from the corresponding author.