Installing Air Purifiers in the Homes of Children With Severe Asthma: Outcomes and Family Perspectives From a Feasibility Study

Background Poor indoor air quality (IAQ) contributes to asthma morbidity, particularly affecting children and young people (CYP) from socioeconomically deprived backgrounds. Air purification devices may improve IAQ and asthma symptoms, but real‐world evidence remains limited. Aim To assess the feasibility, acceptability, and potential clinical impact of installing an air purifier in the homes of CYP with severe asthma. Methods An unblinded feasibility study recruiting children ≤ 15 years with a confirmed diagnosis of asthma attending a regional severe asthma service. Participants selected by computer‐generated random allocation. An air purifier (manufactured by Rensair Ltd.) was installed in each home, with instructions to operate continuously on “quiet mode” for 1‐year, and operating costs covered. Data on asthma management and symptoms, quality of life, and qualitative feedback were collected and analysed using thematic analysis. Results Twenty CYP were recruited (mean age: 11.2 (SD: 2.68), 60% boys). Thematic analysis of feedback from CYP and families indicated high acceptability and perceived improvements in night‐time symptoms and IAQ. Over this 12‐month study period, the mean annual number of systemic corticosteroid courses decreased from 4.2 to 2.15 ( p = 0.006) from the previous year, and unscheduled primary care visits fell from 4.0 to 1.8 ( p = 0.02). Trends towards marginal improvements in asthma control test mean scores (13.3 to.14.2 for < 12 years ( p = 0.2), 15.5 to 16.8 for ≥12 years ( p = 0.6) and quality of life scores were observed (54.6 to 62.4 for total score ( p = 0.08), 17.2 to 19.8 for emotional domain ( p = 0.07) and 13.6 to 13.9 for activity domain ( p = 0.7)), with a statistically significant increase in the symptom domain of the Mini‐PAQLQ (23.8 to 28.8 p = 0.04). Conclusions Air purifiers may offer a feasible, acceptable, and potentially beneficial intervention for children with severe asthma, particularly in settings with poor IAQ. Larger controlled trials are warranted to confirm these findings and inform implementation. Trial Registration NCT05817357.