Researchers found that when nurses visited children at home they found potential asthma triggers, such as smoking, in nearly 80 per cent of cases. The nurses' recommendations on dealing with these factors meant more serious treatment was not needed in more than half of the children visited (55 per cent).
Experts from the Royal Brompton Hospital and Imperial College London studied 71 children under 18 who had problematic asthma.
They organised for a nurse-led hospital visit followed by a home visit which involved looking at allergy exposure, particularly house dust mite and pets, smoking, medication and psychosocial issues.
The main reasons for poor control of asthma were found to be psychosocial factors (59 per cent), medication issues (48 per cent), exposure to allergens (31 per cent), and passive or active smoking (25 per cent).
Most homes (84 per cent) were taking inadequate steps to avoid house dust mites and, in almost a quarter of homes, medications were not easily available for inspection or were out of date.
"We believe the home visit makes an important contribution to the assessment of the child with problematic asthma," the researchers concluded.
The study will appear in the Archives of Disease in Childhood (http://adc.bmj.com).
