School Asthma Documentation Associated With Student Return to Class After Stock Inhaler Use

To evaluate the association between asthma documentation at school (asthma diagnosis and asthma action plan [AAP]) and outcomes after stock inhaler use at school.

This observational study examined respiratory events and outcomes in a statewide program that provided albuterol metered dose inhalers to Illinois public schools. Nurses registered online and reported each inhaler use (event). This report collected individual characteristics, asthma documentation, and event outcomes. Analyses included Pearson's Chi-square tests, Fisher's exact tests, Wilcoxon rank-sum tests, and logistic regression models.

In 2023-2024 school year, 656 events occurred requiring stock inhaler use among students across Illinois schools. Students had an asthma diagnosis on file at school in 63% of events (n = 413); among these students, 42% had an AAP on file (42%, n = 175). For disposition after stock inhaler use, 76% of students returned to class (n = 497). Students with an asthma diagnosis documented at school had 2.6 times higher odds of returning to class after stock inhaler use versus those without documentation (95% CI 1.81-3.75). Similarly, students with asthma who also had AAPs on file at school had 2.41 times higher odds of returning to class after respiratory events versus those without AAPs (95% CI 1.39-4.33). These associations remained significant in adjusted models.

In a statewide stock inhaler program in Illinois, we found students with asthma diagnoses and AAPs documented at school had higher rates of return to class after stock inhaler use for respiratory symptoms compared to students without such documentation.