@article {Edwardse733, author = {Rhiannon T Edwards and Richard D Neal and Pat Linck and Nigel Bruce and Linda Mullock and Nick Nelhans and Diana Pasterfield and Daphne Russell and Ian Russell and Louise Woodfine}, editor = {,}, title = {Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial}, volume = {61}, number = {592}, pages = {e733--e741}, year = {2011}, doi = {10.3399/bjgp11X606645}, publisher = {Royal College of General Practitioners}, abstract = {Background There has been little rigorous economic analysis of the relationship between asthma and improved housing.Aim To evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with {\textquoteleft}moderate{\textquoteright} or {\textquoteleft}severe{\textquoteright} asthma.Design and setting An incremental cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a tailored package of housing modifications designed to improve ventilation and household heating in homes within Wrexham County Borough, Wales, UK.Method A total of 177 children aged between 5 and 14 years, identified from general practice registers, were studied. Parents reported on the quality of life of their children over a 12-month period. General practices reported on health-service resources used by those children, and their asthma-related prescriptions, over the same period.Results The tailored package shifted 17\% of children in the intervention group from {\textquoteleft}severe{\textquoteright} to {\textquoteleft}moderate{\textquoteright} asthma, compared with a 3\% shift in the control group. The mean cost of these modifications was {\textsterling}1718 per child treated or {\textsterling}12300 per child shifted from {\textquoteleft}severe{\textquoteright} to {\textquoteleft}moderate{\textquoteright}. Healthcare costs over 12 months following randomisation did not differ significantly between intervention and control groups. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of {\textsterling}234 per point improvement on the 100-point PedsQL{\texttrademark} asthma-specific scale, with 95\% confidence interval (CI) = {\textsterling}140 to {\textsterling}590. The ICER fell to {\textsterling}165 (95\% CI = {\textsterling}84 to {\textsterling}424) for children with {\textquoteleft}severe{\textquoteright} asthma.Conclusion This novel and pragmatic trial, with integrated economic evaluation, reported that tailored improvement of the housing of children with moderate to severe asthma is likely to be a cost-effective use of public resources. This is a rare example of evidence for collaboration between local government and the NHS.}, issn = {0960-1643}, URL = {https://bjgp.org/content/61/592/e733}, eprint = {https://bjgp.org/content/61/592/e733.full.pdf}, journal = {British Journal of General Practice} }