TY - JOUR T1 - House dust mite allergen avoidance and self-management in allergic patients with asthma: randomised controlled trial JF - British Journal of General Practice JO - Br J Gen Pract SP - 184 LP - 190 VL - 57 IS - 536 AU - Marjolein P de Vries AU - Lisette van den Bemt AU - Karen Aretz AU - Bart PA Thoonen AU - Jean WM Muris AU - Arnold DM Kester AU - Sonja Cloosterman AU - CP Onno van Schayck Y1 - 2007/03/01 UR - http://bjgp.org/content/57/536/184.abstract N2 - Background The efficacy of bed covers that are impermeable to house dust mites has been disputed.Aim The aim of the present study was to investigate whether the combination of ‘house dust mite impermeable’ covers and a self-management plan, based on peak flow values and symptoms, leads to reduced use of inhaled corticosteroids (ICS) than self-management alone.Design of study Prospective, randomised, double blind, placebo-controlled trial.Setting Primary care in a south-eastern region of the Netherlands.Method Asthma patients aged between 16 and 60 years with a house dust mite allergy requiring ICS were randomised to intevention and placebo groups. They were trained to use a self-management plan based on peak flow and symptoms. After a 3-month training period, the intervention commenced using house dust mite impermeable and placebo bed covers. The follow-up period was 2 years. Primary outcome was the use of ICS; secondary outcomes were peak expiratory flow parameters, asthma control, and symptoms.Results One hundred and twenty-six patients started the intervention with house dust mite impermeable or placebo bed covers. After 1 and 2 years, significant differences in allergen exposure were found between the intervention and control groups (P<0.001). No significant difference between the intervention and control groups was found in the dose of ICS (P = 0.08), morning peak flow (P = 0.52), peak flow variability (P = 0.36), dyspnoea (P = 0.46), wheezing (P = 0.77), or coughing (P = 0.41). There was no difference in asthma control between the intervention and control groups.Conclusion House dust mite impermeable bed covers combined with self-management do not lead to reduced use of ICS compared with self-management alone. ER -