School-based supervised therapy programs to improve asthma outcomes: current perspectives
Received 4 May 2018
Accepted for publication 27 June 2018
Published 29 August 2018 Volume 2018:11 Pages 205—215
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Dr Amrita Dosanjh
Guadalupe Salazar, Geeta Tarwala, Marina Reznik
Division of Academic General Pediatrics, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
Background: Asthma is one of the most common chronic diseases of childhood affecting 6.2 million (8.4%) children (<18 years old) in the USA. Asthma is also a leading cause of school absenteeism. Daily administration of preventive asthma medications improves asthma control. However, poor medication adherence is one of the barriers in achieving improved asthma outcomes. School-based supervised asthma therapy programs have been implemented to address this barrier.
Objectives: To conduct a review of the literature on school-based supervised asthma therapy interventions and the effect on outcomes in children with persistent asthma.
Methods: We conducted a literature search using electronic search engines (ie, PubMed and Cochrane) and combinations of different search terms “school-based asthma,” “school-based asthma therapy,” and “school-based supervised asthma therapy.” Inclusion criteria were school-based interventions with supervised asthma medication administration conducted in the USA, measuring asthma outcomes. From 443 titles and abstracts, 9 studies met the inclusion criteria.
Results: School-based interventions with supervised asthma medication administration revealed improvement in asthma outcomes, including improved medication adherence, increased symptom-free days, decreased daytime and nighttime symptoms, decreased use of rescue medication, decreased asthma-related health care utilization, fewer exacerbations requiring treatment with prednisone, decreased school absenteeism due to asthma, fewer days of activity limitation, improved quality of life, and improvement in both pulmonary inflammatory markers and peak flow readings.
Conclusion: Our literature review demonstrated that school-based supervised asthma therapy improves asthma outcomes in urban children with persistent asthma. Schools are an ideal setting for implementation of asthma interventions for children and adolescents.
Keywords: directly observed therapy, inhaled corticosteroids, medication adherence, interventions, children, schools
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