Division of Allergy, Asthma & Immunology, Children's Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Division of Toxicology and Environmental Health, Children's Mercy, Kansas City, USA.
Curr Allergy Asthma Rep. 2018 Feb 22;18(3):17. doi: 10.1007/s11882-018-0774-x.
The use of environmental interventions to improve outcomes in asthmatics has long been an elusive goal. While numerous interventions have been studied, the results of clinical trials have been mixed. This review aims to identify combinations of interventions that have been proven to be effective and to propose a model for using them in a clinical setting.
An NIH workshop emphasized a need for research to identify effective interventions for reducing indoor exposures and improving asthma outcomes. A number of innovative measures were described, though evidence supporting their use was lacking. A recent systematic review described various interventions for which evidence is available. The greatest challenge for this approach is the same as that for the medical approach to treatment: nonadherence. Given evidence for effective interventions, control of environmental exposures should lead to improved asthma outcomes. Methods to improve adherence need to be identified.
长期以来,人们一直希望通过环境干预来改善哮喘患者的预后。虽然已经研究了许多干预措施,但临床试验的结果喜忧参半。本综述旨在确定已被证明有效的干预措施组合,并提出在临床环境中使用这些干预措施的模型。
美国国立卫生研究院(NIH)的一次研讨会强调,需要研究确定有效的干预措施,以减少室内暴露并改善哮喘预后。虽然描述了一些创新措施,但缺乏对其使用的证据支持。最近的一项系统评价描述了各种有证据支持的干预措施。这种方法面临的最大挑战与治疗的医学方法相同:不依从。鉴于有效的干预措施的证据,控制环境暴露应能改善哮喘预后。需要确定提高依从性的方法。