Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

Edwards, Rhiannon Tudor; Neal, Richard D; Linck, Pat; Bruce, Nigel; Mullock, Linda; Nelhans, Nick; Pasterfield, Diana; Russell, Daphne; Russell, Ian; Woodfine, Louise

doi:10.3399/bjgp11x606645

Cited by 35 publications

(25 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there is no evidence of effect on psychosocial quality of life or health-service use. 18 The PedsQL asthma scale sums 28 items, each on a 5-point Likert scale, and converts that sum to a score between 0 and 100; thus, the observed mean difference of 7.1 points represents a change of 1 Likertscale point (for example, from 'often' to 'sometimes' experiencing problems) on about 8 of the 28 items. However, even relatively small shifts in mean score can have a large effect on the proportion of a population with 'serious' problems.…”

Section: Discussionmentioning

confidence: 99%

“…The companion economic analysis evaluates whether the intervention is costeffective as well as effective. 18 Further …”

Section: Implications For Practice and Researchmentioning

confidence: 99%

“…The companion economic paper tests whether these improvements change the use of health care, including medication. 18 This study used a pragmatic trial design to decide whether to invest in ventilation systems, rather than to test scientific hypotheses under laboratory conditions. 19,20 For example, housing officers were encouraged to adapt ventilation systems to individual circumstances.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

et al. 2011

Self Cite

View full text Add to dashboard Cite

BackgroundFew robust studies have tested whether enhancing housing also improves health. AimTo evaluate the effectiveness of installing ventilation systems, and central heating where necessary, in the homes of children with moderate or severe asthma. Design and settingPragmatic randomised controlled trial (RCT) in homes within Wrexham County Borough, Wales, UK. MethodA pragmatic RCT was carried out, of a tailored package of housing improvements providing adequate ventilation and temperature, following inspection by a housing officer. One hundred and ninety-two children with asthma aged 5 to 14 years, identified from general practice registers, were randomised to receive this package, either immediately or a year after recruitment. At baseline, and after 4 and 12 months, parents reported their child's asthma-specific and generic quality of life, and days off school. ResultsThe package improved parent-reported asthmaspecific quality of life significantly at both 4 and 12 months. At 12 months, this showed an adjusted mean difference between groups of 7.1 points (95% confidence interval [CI] = 2.8 to 11.4, P = 0.001): a moderate standardised effect size of 0.42. The generic quality-of-life scale showed reported physical problems were significantly reduced at 4 months, but not quite at 12 months, when the mean difference was 4.5 (95% CI = -0.2 to 9.1, P = 0.061). The improvement in psychosocial quality of life at 12 months was not significant, with a mean difference of 2.2 (95% CI = -1.9 to 6.4, P = 0.292). Parent-reported school attendance improved, but not significantly. ConclusionThis novel and pragmatic trial, with integrated economic evaluation, found that tailored improvement of the housing of children with moderate to severe asthma significantly increases parent-reported asthma-related quality of life and reduces physical problems. Collaborative housing initiatives have potential to improve health.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The companion economic analysis evaluates whether the intervention is costeffective as well as effective. 18 Further …”

Section: Implications For Practice and Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

et al. 2011

Self Cite

View full text Add to dashboard Cite

show abstract

“…These studies were published recently and were not included in the original systematic review 53 54. Edwards et al 53 report an economic evaluation, as defined here, presenting an estimate of the additional cost per point improvement on the PedsQL asthma specific scale. Grimes et al 54 present a ‘balance sheet’ approach with a calculation of net economic benefit.…”

Section: Resultsmentioning

confidence: 99%

Economic analysis of the health impacts of housing improvement studies: a systematic review

Fenwick

Macdonald

Thomson

2013

J Epidemiol Community Health

View full text Add to dashboard Cite

BackgroundEconomic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing.MethodsData were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics.Results25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo.ConclusionsFuture studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy.

show abstract

“…Problems in evidence of AB, leading to disproportional evidence of AB in individual regions, are also significant (Gudelj et al, 2012;Hansen et al, 2012). An exact and early diagnosis can significantly reduce progression of clinical manifestation of AB and thus strongly lower financial burden (Bahadori et al, 2009;Litonjua and Weiss, 2007;Edwards et al, 2011;Doz et al, 2013;Pohunek et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Asthma Bronchiale in the Czech Republic and its Economic Burden

Josef¹,

Vlastimil²,

Lucie³

et al. 2016

American Journal of Immunology

View full text Add to dashboard Cite

show abstract

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

Cited by 35 publications

References 19 publications

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

Economic analysis of the health impacts of housing improvement studies: a systematic review

Prevalence of Asthma Bronchiale in the Czech Republic and its Economic Burden

Contact Info

Product

Resources

About