xRead - September 2022

Wise et al.

Page 356

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.A.2. Evidence of the effectiveness of cockroach avoidance and environmental controls on the management of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Le Cann et al. 1132 2016 1a SR of RCTs Home group interventions in 3 categories: 1 Education-based methods; 2 Physical methods; 3 Combination of both. Interventions included multiple-allergen control measures. Allergic and respiratory symptoms (eg, cough, daytime symptoms, wheeze, night time symptoms); lung function; medication use; urgent care use for respiratory symptoms Overall studies supported effectiveness of home interventions in decreasing respiratory symptoms and urgent care use. Sever et al. 1133 2007 1b 3-arm RCT; follow up for 12 months 1 Insecticide baits and CR monitoring; 2 Pest control by randomly assigned commercial company; 3 Control No direct clinical endpoints. CR trap counts and CR allergen levels (Bla g 1 and Bla g 2) Significant reduction in CR counts in both treatment groups vs control. Insecticide bait traps more effective in reducing CR infestation than sprays. Elimination of CR populations leads to reduction in CR allergen and exposure. Eggleston et al. 1141 2005 1b RCT 1 Home-based education, CR and rodent extermination, mattress and pillow encasings, HEPA filters; 2 Control Primary outcome: Bla g 1 CR allergen level. Secondary outcome: asthma symptoms CR allergen reduced by 51% at 6 months. in treatment group but not sustained at 1 year; only modest effect on morbidity. McConnell et al. 1134 2005 1b RCT 1 Education-based intervention (sealing cracks and crevices; cleaning with bleach solutions; insecticide bait traps); 2 Comparison group No direct clinical endpoints; CR count and CR allergen level Achieved 60% reduction in CR count in intervention group. Greatest reduction in allergen level in homes with heavier CR infestation but levels still higher than median level associated with severe symptoms. Arbes et al. 1135 2004 1b RCT with crossover of control group 1 Intervention: education; insecticide bait placement; professional cleaning; 2 Control: no intervention for months 0–6; insecticide bait placement at months 6 and 9 No direct clinical endpoints, Bla g 1 and Bla g 2 CR allergen level CR allergen levels reduced in 6 months with professional cleaning and insecticide bait traps; but lower CR allergen levels maintained at month 12 with bait traps alone. Morgan et al. 1142 2004 1b RCT with blocked randomization 1 Education-based intervention (environmental remediation for Asthma symptoms, use of healthcare services

Intervention group: Reduced levels of CR allergen in bedroom were strongly correlated with decreased asthma-related morbidity.

multiple allergens); professional pest control provided for CR-sensitized children 2 Control

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.