Related Experiment Video
Updated: Jul 26, 2025
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
The role of supervised school therapy in poorly controlled asthma in children
Muppala Raju1, Malvika Sagar2, Andrew Bush3
1Department of Pediatrics, Baylor Research Institute, Temple, Texas.
Insights
Administering inhaled corticosteroids (ICS) at school improved asthma control in children. This intervention reduced hospital admissions and enhanced lung function, offering a promising strategy for managing pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Respiratory Health
Background:
- Nonadherence to inhaled corticosteroid (ICS) therapy is a significant challenge in pediatric asthma management.
- Poor adherence leads to suboptimal disease control and increased risk of complications in children.
Purpose of the Study:
- To evaluate the clinical benefits of initiating once-daily ICS administration at school for children with poorly controlled asthma.
- To assess the impact of school-based ICS therapy on key asthma control metrics.
Main Methods:
- Retrospective study of pediatric patients with poorly controlled asthma prescribed daily ICS.
- Data collection included corticosteroid courses, emergency room visits, hospital admissions, symptom history, and pulmonary function tests before and after intervention.
Main Results:
- Hospital admissions decreased significantly postintervention (1.23 to 0.57, P=0.04).
- Forced expiratory volume in 1 second (FEV1) significantly increased (1.69 vs 1.4 L/sec, P=0.02).
- Systemic steroid-free days increased (96 to 141 days, P=0.03), indicating reduced need for oral corticosteroids.
Conclusions:
- School-based ICS administration is a viable strategy to improve asthma control in children.
- This approach may lead to reduced hospitalizations and enhanced lung function in pediatric asthma patients.
Background:
In children, nonadherence to inhaled corticosteroid (ICS) therapy leads to poor asthma control and complications.
Methods:
We evaluated the benefit from initiation of ICS administration once daily at school. We retrospectively chose patients from our pediatric pulmonary clinic who had poorly controlled asthma and prescribed ICS daily. For the study period, we examined the number of corticosteroid courses, emergency room visits, hospital admissions, symptom history, and pulmonary function tests.
Results:
Thirty-four patients who satisfied the inclusion criteria began the intervention. Preintervention, there were a mean number of 2.6 oral corticosteroid courses compared to 2 courses in the year following intervention (P = 0.8). Postintervention emergency department visits decreased from a mean of 1.4 to 1.0 (P = 0.71), and hospital admissions decreased from 1.23 to 0.57 (P = 0.04). There was also a significant increase in forced expiratory volume in 1 second (1.69 vs 1.4 L/sec, P = 0.02), a decrease in systemic steroid-free days in a year (96 vs 141 days, P = 0.03), and an increase in symptom-free days postintervention (28 vs 26 days, P = 0.325).
Conclusion:
These findings suggest that ICS administration in schools may help reduce hospital admissions and improve lung function in patients with poorly controlled asthma.
Related Concept Videos
01:29Asthma-I: Introduction
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:30Asthma-IV: Nursing Management
First, in...
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.