Achieving and maintaining asthma control in inner-city children

Area of Science:

• Pediatric Pulmonology
• Public Health
• Asthma Management

Background:

• Inner-city children from low socioeconomic backgrounds often experience poor asthma control despite adherence to guidelines.
• Barriers to effective asthma care disproportionately affect vulnerable pediatric populations.

Purpose of the Study:

• To evaluate the effectiveness of mobile asthma clinics (Breathmobile Program) in achieving and maintaining asthma control for pediatric patients.
• To identify factors associated with well-controlled asthma in a high-risk population.

Main Methods:

• Retrospective analysis of clinical data from 7822 pediatric asthma patients across US mobile asthma programs (1998-2008).
• Evaluation of asthma control's impact on morbidity, time to control, control maintenance, and associated factors.
• Data included emergency department visits, hospitalizations, and missed school days.

Main Results:

• Significant reductions observed in emergency department visits (66%), hospitalizations (84%), and missed school days (78%) after program enrollment.
• Approximately 80% of patients achieved well-controlled asthma by the third visit.
• Factors associated with improved control included non-African American race, visit intervals under 90 days, and adherence to therapy.

Conclusions:

• Intensive, accessible, guidelines-defined care delivered via mobile clinics can achieve and maintain asthma control in high-risk pediatric populations.
• Close follow-up and reduced barriers are crucial for managing pediatric asthma in underserved communities.