Clinical Effectiveness and Economical Impact of Medical Indoor Environment Counselors Visiting Homes of Asthma Patients

NCT ID: NCT02212483

Last Updated: 2023-05-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

107 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-05

Study Completion Date

2020-03-05

Brief Summary

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Asthma is one of the most prevalent chronic respiratory diseases, with potential lifethreatening impacts. Indeed, asthma is still responsible for about a thousand deceases per year in France, and constitutes a public health problem in our country as in many countries in the world. The economic burden of asthma is also very high, in terms of health care, and indirect costs including lost work and lost school days.

A few international and French studies have shown a positive clinical impact of Medical Indoor Environment Counselors (MIECs) visiting homes of asthma patients, mainly pediatrics. It has been proposed that MIECs could contribute to reduce patient exposure to many allergens and irritants, among them, house dust mite allergens, formaldehyde or molds. Most of the studies that show a significant decrease of hospitalization or visit in an emergency ward for asthma are monocentric and study the eviction of 1 such identified risk factor. By contrast, meta-analysis underline that additional studies are needed to evaluate the effectiveness of these interventions in adults, in a multicentric and controlled manner, with both clinical, environmental and economical endpoints.

Detailed Description

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Methodology/Study schedule :

A prospective multicenter randomised, open label, controlled trial with blind evaluation of the primary evaluation criterion on three parallel groups of patients.

Procedures :

Home intervention of MIECs that comprise diagnostic of allergen/irritant exposure (after sampling), advices for allergen/irritant avoidance and follow up of advice compliance.

After randomisation and agreement of the patient and the family, the " intervention group " will benefit from a first home intervention of a MIEC during the 4 weeks following inclusion, then a final visit at the end of the study after 12 months.

Two comparative groups will be identified :

* the " control group " who will benefit from a first home intervention of a MIEC but without advices (only audit + sampling), then a final and a complete visit at the end of the study
* a " non intervention " group with no initial visit, but who will benefit from a complete home intervention of a MIEC at the end of the study.

Substantial modification of the 20th of June, 2016 : Modification of the design : change into a 2 parallel groups evaluation Justification: At its meeting of June 1, 2016, considering the inclusion difficulties, the Scientific Council decided to give up the "Control" group.

The study design is then : a prospective multicenter randomised, open label, controlled trial with blind evaluation of the primary evaluation criterion on three parallel groups of patients.

The objective is to recruit 50 to 70 patients by arm.

Expected findings and impact :

If our hypothesis that home intervention of MIECs are cost-effective on asthma control, then it is relevant to include such service in the medical care during the management of asthma patients with a reimbursement by the social security.

Conditions

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Asthma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors
Substantial modification of the 20th of June, 2016 : Modification of the design : change into a 2 parallel groups evaluation Justification: At its meeting of June 1, 2016, considering the inclusion difficulties, the Scientific Council decided to give up the "Control" group.

The study design is then : a prospective multicenter randomised, open label, controlled trial with blind evaluation of the primary evaluation criterion on three parallel groups of patients.

The objective is to recruit 50 to 70 patients by arm.

The Control group will still be described.

Study Groups

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Intervention group

After randomisation and agreement of the patient and the family, the " intervention group " will benefit from a first home intervention of a MIEC during the 4 weeks following inclusion, then a final visit at the end of the study after 12 months.

Group Type EXPERIMENTAL

First home intervention with advice

Intervention Type OTHER

A first home intervention of a MIEC during the 4 weeks following inclusion, with sampling, audit and advices.

Final home visit

Intervention Type OTHER

Final home visit at the end of the study after 12 months, with sampling and home audit.

For the "intervention group", checking of the advice compliance. For the both comparative groups, delivery of advices.

Control group

The " control group " is one of the two comparative groups who will benefit from a first home intervention of a MIEC but without advices (only audit + sampling), then a final and a complete visit at the end of the study.

This group has been suppressed with the last amendment. But data of the subjects included in this group will be analyzed.

Group Type ACTIVE_COMPARATOR

First home intervention without any advice

Intervention Type OTHER

A first home intervention of a MIEC during the 4 weeks following inclusion, with sampling, home audit but without any advice.

Final home visit

Intervention Type OTHER

Final home visit at the end of the study after 12 months, with sampling and home audit.

For the "intervention group", checking of the advice compliance. For the both comparative groups, delivery of advices.

Non intervention group

The " non intervention " group is the second comparative group with no initial visit, but will benefit from a complete home intervention of a MIEC at the end of the study.

Group Type OTHER

Final home visit

Intervention Type OTHER

Final home visit at the end of the study after 12 months, with sampling and home audit.

For the "intervention group", checking of the advice compliance. For the both comparative groups, delivery of advices.

Interventions

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First home intervention with advice

A first home intervention of a MIEC during the 4 weeks following inclusion, with sampling, audit and advices.

Intervention Type OTHER

First home intervention without any advice

A first home intervention of a MIEC during the 4 weeks following inclusion, with sampling, home audit but without any advice.

Intervention Type OTHER

Final home visit

Final home visit at the end of the study after 12 months, with sampling and home audit.

For the "intervention group", checking of the advice compliance. For the both comparative groups, delivery of advices.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* age greater than or equal to 6 years and less than 45 (\<45 years),
* patients with an eligible control level of asthma,
* sensitization to one or more allergens demonstrated during the last 36 months with prick tests (papules with a diameter \> 3 mm compared to a negative control or \> 50% of positive control) and/or specific IgE detection (\> 0.10 U/mL),
* patients \> 15 years presenting with a reversibility to ß2-agonists \> 200 mL and/or \> 12% compared to the initial FEV1 value (test performed at least once in life) or patients ≥ 6 years and ≤ 15 years presenting with a reversibility to ß2-agonists \> 200 mL and/or \> 12% compared to the initial FEV1 value (at least once in the life) and/or a positive metacholine challenge (at least once in the life),
* patients sleeping \> 6 nights per week in the same house
* individuals affiliated to 1 of the 3 French social security (for matching data from French social security via SNIIRAM system),
* Only one patient per dwelling,
* Patient oral consent (written attestation by investigator)

Exclusion Criteria

* chronic obstructive pulmonary disease (COPD),
* identified occupational asthma,
* Move within the 6 months before home intervention or predicted during the first year of inclusion,
* advices provided during the 2 years before inclusion during a home intervention of a MIEC
* active smokers or smoker who given up smoking less than 5 years ago, with a consumption of more than 10 years of 20 cigarettes/day, OR smoker who given up smoking more than 5 years ago, with a consumption of more than 20 years of 20 cigarettes/day,
* patients \< 18 years for whom the parents (or legal guardian) are opposed to the inclusion in ECENVIR study,
* Major people being the object of a legal protection (protection(saving) of justice, guardianship, supervision(guardianship)) and private persons of freedom
Minimum Eligible Age

6 Years

Maximum Eligible Age

44 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ecole des Hautes Etudes en Santé Publique

OTHER

Sponsor Role collaborator

Institut de Recherche et Documentation en Economie de la Santé, France

OTHER

Sponsor Role collaborator

Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role collaborator

Rennes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Pierre Gangneux, MD

Role: PRINCIPAL_INVESTIGATOR

Rennes University Hospital

Locations

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Strasbourg UH

Strasbourg, Alsace, France

Site Status

Aix-en-Provence Hospital

Aix-en-Provence, , France

Site Status

Bordeaux University Hospital

Bordeaux, , France

Site Status

Caen University Hospital

Caen, , France

Site Status

Chalon

Chalon-sur-Saône, , France

Site Status

Chauny Hospital

Chauny, , France

Site Status

Dijon University Hospital

Dijon, , France

Site Status

Grenoble University Hospital

Grenoble, , France

Site Status

Lille UH

Lille, , France

Site Status

Marseille European Hospital

Marseille, , France

Site Status

Marseille University Hospital

Marseille, , France

Site Status

Macon Hospital

Mâcon, , France

Site Status

Nantes University Hospital

Nantes, , France

Site Status

Reims University Hospital

Reims, , France

Site Status

Rouen University Hospital

Rouen, , France

Site Status

Vire Hospital

Vire, , France

Site Status

Countries

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France

References

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Le Cann P, Paulus H, Glorennec P, Le Bot B, Frain S, Gangneux JP. Home Environmental Interventions for the Prevention or Control of Allergic and Respiratory Diseases: What Really Works. J Allergy Clin Immunol Pract. 2017 Jan-Feb;5(1):66-79. doi: 10.1016/j.jaip.2016.07.011. Epub 2016 Sep 21.

Reference Type RESULT
PMID: 27665387 (View on PubMed)

Gangneux JP, Bouvrais M, Frain S, Morel H, Deguen S, Chevrier S, Le Cann P. Asthma and Indoor Environment: Usefulness of a Global Allergen Avoidance Method on Asthma Control and Exposure to Molds. Mycopathologia. 2020 Apr;185(2):367-371. doi: 10.1007/s11046-019-00417-9. Epub 2020 Jan 2.

Reference Type RESULT
PMID: 31897973 (View on PubMed)

Other Identifiers

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2012-A01414-39

Identifier Type: OTHER

Identifier Source: secondary_id

12/42-875

Identifier Type: OTHER

Identifier Source: secondary_id

13.424

Identifier Type: OTHER

Identifier Source: secondary_id

913428

Identifier Type: OTHER

Identifier Source: secondary_id

35RC12_9713_ECENVIR

Identifier Type: -

Identifier Source: org_study_id

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