The School-Based Preventive Asthma Care Trial: Results of a Pilot Study

Abstract

Objective To test the feasibility and preliminary effectiveness of the SB-PACT program, which includes directly observed therapy of preventive asthma medications in school facilitated by web-based technology for systematic symptom screening, electronic report generation, and medication authorization from providers. Study design We conducted a pilot randomized trial of SB-PACT vs. usual care with 100 children (ages 3-10yrs) from 19 inner-city schools in Rochester, NY. Outcomes were assessed longitudinally by blinded interviewers. Analyses included bivariate statistics and linear regression models, adjusting for baseline symptoms. Results 99 subjects had data for analysis. We screened all children using the web-based system, and 44/49 treatment children received directly observed therapy as authorized by their providers. Treatment children received preventive medications 98% of the time they were in school. Over the school year, children in the treatment group experienced nearly 1 additional symptom-free day/two weeks vs. usual care (11.33 vs. 10.40,p=.13). Treatment children also experienced fewer symptom nights (1.68 vs. 2.20,p=.02), days requiring rescue medications (1.66 vs. 2.44,p=.01) and days absent from school due to asthma (.37 vs. .85,p=.03) compared with usual care. Further, treatment children had a greater decrease in exhaled nitric oxide (−9.62 vs. −.39,p=.03), suggesting reduction in airway inflammation. Conclusion The SB-PACT intervention demonstrated feasibility and improved outcomes across multiple measures in this pilot study. Future work will focus on further integration of preventive care delivery across community and primary care systems.

Effects of an Asthma Training and Monitoring Program on Children's Disease Management and Quality of Life

“…These findings support the second hypothesis. In other studies, the rate of children experiencing asthma symptoms was between 59% and 69% [3,10], and the number of days children experienced asthma symptoms was 1.3-5.31 [7,10,15]. …”

“…Moreover, some children developing certain symptoms of the disease cannot continue their education or meet their nutrition, sleep, and hygienic requirements. Consequently, the children's quality of life decreases [7][8][9][10][11]. Asthma attacks result in an increased number of emergency service consultations, hospital-administered treatments [1], and medication uses [7,12].…”

“…Consequently, the children's quality of life decreases [7][8][9][10][11]. Asthma attacks result in an increased number of emergency service consultations, hospital-administered treatments [1], and medication uses [7,12]. The quality of life of parents also decreases, and the number of days the parents are unable to go to work increases [7,10].…”

“…Asthma attacks result in an increased number of emergency service consultations, hospital-administered treatments [1], and medication uses [7,12]. The quality of life of parents also decreases, and the number of days the parents are unable to go to work increases [7,10]. All these factors result in additional expenses affecting the family and national budgets [1].…”

School-based supervised therapy programs to improve asthma outcomes: current perspectives

“…Although the search was done from the oldest article available on PubMed and Cochrane, the oldest article which met our inclusion criterion was from 2004 as DOT programs started in the past decade. All studies were conducted in the US – 5 in New York State,11–15 1 in Washington DC,16 1 in Alabama,17 1 in Massachusetts,10 and 1 in Texas 18. All studies were conducted in urban populations 10–18.…”