Articles on enhancing ventilation in homes of children with asthma published
Two articles in the British Journal of General Practice are part authored by researchers from Bangor University. Members of the University's Centre for Health Economics and Medicines Evaluation worked with colleagues at the North Wales Public Health Team, Wrexham County Borough Council, the Universities of Cardiff, Bangor and Liverpool, and Betsi Cadwaladr University Health Board to research related to asthma in schoolchildren.
The first article describes a multi-agency randomised controlled trial (RCT) conducted to test the effects of improving ventilation and heating in the homes of schoolchildren with asthma. Work on the trial has already won the UK Association of Public Service Excellence Award and was also runner up in the NHS Wales Awards 2009.
The Children’s Health in Asthma: Research to Improve Status through Modifying Accommodation (CHARISMA) trial was a collaboration between local government, the NHS and academic colleagues. As well as forming a research project to inform the health and housing evidence base and improve the asthmatic health and well-being of schoolchildren, CHARISMA also looks at more effective and different ways of delivering local authority services to improve health and well-being and complements existing health care service delivery in primary and secondary care.
The CHARISMA trial commenced in 2004 when eligible families were identified and recruited. The trial looked at the effect of enhancing ventilation and in some cases central heating, in the homes of children with moderate or severe asthma. It involved nearly 200 children identified through GP surgeries within the Wrexham County Borough area. The homes of participants were surveyed by the local authority before being allocated randomly into groups that would have improved ventilation and central heating installed immediately (intervention group) or would have to wait for 12 months for improvements to be made (control group). The aim of the trial was to see if improvements in the ventilation and heating of the homes of children with asthma had an effect on the child’s asthma and also on their overall quality of life and well-being.
The study concludes that the installation of ventilation and central heating in school children with moderate or severe asthma significantly improved their asthma specific quality of life. The child’s physical problems and psychosocial health also improved. The intervention may also reduce school absence and improve the health of siblings and other household members.
The second published article describes a cost-effectiveness study that ran alongside the RCT. This study was lead by Prof Rhiannon Tudor Edwards, co-Director of the Centre for Health Economics and Medicines Evaluation, IMSCaR. It found that such a tailored approach to improving the housing of children with moderate to severe asthma was likely to be a cost-effective and good use of public resources.
Following the positive results of the trial, during 2010/2011 a further 50 homes were modified by linking with every GP surgery in Wrexham and during 2011/2012 an additional 15 homes will be modified.
Louise Woodfine, Principal Public Health Officer, Public Health Wales, said: “This is an innovative cost effective project that has improved the children’s asthma and their overall quality of life and shown the real benefits of partnership working between local government, the NHS and academia. The impact of asthma on children and their family members can be devastating and can easily be underestimated. CHARISMA has the potential to improve the lives of thousands of asthmatic children and their families as well as helping to avoid hospital admissions every year.”
For access to the full articles in the British Journal of General Practice, November 2011, follow (Athens access required): http://www.rcgp.org.uk/brjgenpract.aspx
More information on the North Wales Public Health Team is available at: http://www.wales.nhs.uk/sitesplus/888/page/46346
Wrexham team win Association of Public Service Excellence Award (February 2010): http://www.wales.nhs.uk/sitesplus/888/news/15356
Publication date: 17 January 2012