Incorporating Aeroallergen Exposure Metrics into Clinical Asthma Care: A Pilot Study Using A Mixed-Methods Survey to Assess Aeroallergen Knowledge, Perceived Asthma Control, and Mitigation Strategies in Households of Children with Asthma.

Abstract

Objective: Mitigation of household allergens is associated with the reduction of asthma exacerbations in those with allergic asthma and is recommended in recent asthma guidelines. However, we need to better understand patient knowledge of aeroallergens in their homes prior to integrating direct allergen measurement methods into standard asthma care. Methods: We conducted a mixed-methods sequential pilot study consisting of a survey and virtual interview with caregivers of children aged 3 to 15 with asthma diagnosis (any severity) about asthma control, household environment, mitigation knowledge and strategies, and knowledge of allergens and asthma. Results: A total of 21 participants responded and 13 completed the virtual interview. Less than half identified mice (43%), rats (29%), and cockroaches (43%) as sources of allergens on the online survey, and no individuals mentioned these in discussions. Only 23% were able to define the term "allergen," but 69% could list examples. There was a poor correlation between perceived asthma control (57% stated asthma control was good or excellent) compared to asthma that was classified as well controlled per Expert Panel Report 3 (EPR-3) guidelines (33% based on albuterol use and asthma symptoms). Finally, visual identification of mouse infestation was associated with active steps taken to mitigate mouse exposure (P = 0.007). Conclusion: Implementation of new Asthma Management Guidelines: Focused Updates 2020 by the National Institutes of Health will require additional aeroallergen education for individuals with asthma who do not recognize that cockroaches, rats, and mice can cause asthma symptoms, do not know the definition of an allergen, and do not correctly perceive asthma control status. Environmental assessment with education addressing these could hopefully decrease additional pharmaceutical needs.