Dataset Information

Randomized controlled trial to improve care for urban children with asthma: results of the School-Based Asthma Therapy trial.

ABSTRACT:

Objective

To evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.

Design

Randomized trial, with children stratified by smoke exposure in the home and randomized to a school-based care group or a usual care control group.

Setting

Rochester, New York.

Participants

Children aged 3 to 10 years with persistent asthma.

Interventions

Directly observed administration of daily preventive asthma medications by school nurses (with dose adjustments according to National Heart, Lung, and Blood Institute Expert Panel guidelines) and a home-based environmental tobacco smoke reduction program for smoke-exposed children, using motivational interviewing.

Main outcome measure

Mean number of symptom-free days per 2 weeks during the peak winter season (November-February), assessed by blinded interviews.

Results

We enrolled 530 children (74% participation rate). During the peak winter season, children receiving preventive medications through school had significantly more symptom-free days compared with children in the control group (adjusted difference = 0.92 days per 2 weeks; 95% confidence interval, 0.50-1.33) and also had fewer nighttime symptoms, less rescue medication use, and fewer days with limited activity (all P < .01). Children in the treatment group also were less likely than those in the control group to have an exacerbation requiring treatment with prednisone (12% vs 18%, respectively; relative risk = 0.64; 95% confidence interval, 0.41-1.00). Stratified analyses showed positive intervention effects even for children with smoke exposure (n = 285; mean symptom-free days per 2 weeks: 11.6 for children in the treatment group vs 10.9 for those in the control group; difference = 0.96 days per 2 weeks; 95% confidence interval, 0.39-1.52).

Conclusions

The School-Based Asthma Therapy intervention significantly improved symptoms among urban children with persistent asthma. This program could serve as a model for improved asthma care in urban communities.

SUBMITTER: Halterman JS

PROVIDER: S-EPMC3600609 | biostudies-literature | 2011 Mar

REPOSITORIES: biostudies-literature

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Publications

Randomized controlled trial to improve care for urban children with asthma: results of the School-Based Asthma Therapy trial.

Halterman Jill S JS Szilagyi Peter G PG Fisher Susan G SG Fagnano Maria M Tremblay Paul P Conn Kelly M KM Wang Hongyue H Borrelli Belinda B

Archives of pediatrics & adolescent medicine 20110301 3

<h4>Objective</h4>To evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.<h4>Design</h4>Randomized trial, with children stratified by smoke exposure in the home and randomized to a school-based care group or a usual care control group.<h4>Setting</h4>Rochester, New York.<h4>Participants</h4>Children aged 3 to 10 years with persistent asthma.<h4>Interventions</h4>Directly observed administration of daily preventive asthma med ...[more]

PMID: 21383275

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Dataset Information

Randomized controlled trial to improve care for urban children with asthma: results of the School-Based Asthma Therapy trial.

Objective

Design

Setting

Participants

Interventions

Main outcome measure

Results

Conclusions

Publications

Randomized controlled trial to improve care for urban children with asthma: results of the School-Based Asthma Therapy trial.

Similar Datasets

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