Asthma and lower airway diseaseAchieving and maintaining asthma control in inner-city children
Section snippets
Study population
This study evaluated asthma control for patients enrolled in similarly structured mobile asthma programs previously described13, 14 for the following sites (program name, launch date): Los Angeles, Calif (Los Angeles County + University of Southern California Pediatric Asthma Disease Management Program, LAC+USC PADMAP, Breathmobile Program, November 16, 1995), Chicago, Ill (Mobile Children's Asthma Research and Education [C.A.R.E.] Foundation, November 9, 1999), Baltimore, Md (University of
Patient demographics
Table I describes the patient populations with regional variations noted (P < .05). Subjects had a mean age of 8.6 years (SD, 3.4) and a median number of 4 program visits/year (interquartile range, 2-5); the median visit interval length was 56 days (interquartile range, 42-91 days; visit data not presented in Table I). Ethnicity and race varied by site (overall, 67% Hispanic vs 33% non-Hispanic; 22% African American, 5% Caucasian, and 6% other). Nearly half of patients had a BMI ≥85% (similar
Discussion
African American and Hispanic children with asthma living in underserved areas have the highest asthma-related morbidity and mortality, yet have limited access to specialty-based asthma care to improve asthma-related outcomes effectively.10, 19, 20, 21, 22, 23, 24, 25, 26, 27 Implementation of the Breathmobile program sought to remove barriers to care, providing preventive specialty-based asthma care to this high-risk population.11, 13 Participation in this program is associated with reductions
References (59)
- et al.
Achieving and maintaining asthma control in an urban pediatric disease management program: the Breathmobile Program
J Allergy Clin Immunol
(2007) - et al.
Improvement of asthma control with omalizumab in 2 obese pediatric asthma patients
Ann Allergy Asthma Immunol
(2006) - et al.
Outcome of asthma in children and adolescents at a specialty-based care program
Ann Allergy Asthma Immunol
(2001) - et al.
Racial and income disparities in childhood asthma in the United States
Ambul Pediatr
(2002) Asthma disparities in urban environments
J Allergy Clin Immunol
(2009)Advances in pediatric asthma in 2009: gaining control of childhood asthma
J Allergy Clin Immunol
(2010)- et al.
School-based asthma programs
J Allergy Clin Immunol
(2009) - et al.
Asthma control and future asthma-related morbidity in inner-city asthmatic children
Ann Allergy Asthma Immunol
(2008) - et al.
Emergency department visits by urban African American children with asthma
J Allergy Clin Immunol
(2000) - et al.
Improved asthma outcomes from allergy specialist care: a population-based cross-sectional analysis
J Allergy Clin Immunol
(2005)
A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study
J Pediatr
Achieving asthma control in the inner city: do the National Institutes of Health Asthma Guidelines really work?
J Allergy Clin Immunol
Management of asthma based on exhaled nitric oxice in addition to guideline-based treatment for inncer city adolescents and young adults: a randomized controlled trial
Lancet
The impact of health insurance gaps on access to care among children with asthma in the United States
Ambul Pediatr
Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma
J Allergy Clin Immunol
Asthma in the inner city and the indoor environment
Immunol Allergy Clin North Am
The environment and asthma in US inner cities
Chest
Urban asthma and the neighbourhood environment in New York City
Health Place
Supporting successful asthma mangement in schools: the role of asthma care providers
J Allergy Clin Immunol
Mouse exposure and wheeze in the first year of life
Ann Allergy Asthma Immunol
Household mouse allergen exposure and asthma morbidity in inner-city preschool children
Ann Allergy Asthma Immunol
Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of asthma-summary report 2007
J Allergy Clin Immunol
Global strategy for asthma management and prevention: GINA executive summary
Eur Respir J
Status of childhood asthma in the United States, 1980-2007
Pediatrics
Inadequate therapy for asthma among children in the United States
Pediatrics
Urban minority children with asthma: substantial morbidity, compromised quality and access to specialists, and the importance of poverty and specialty care
J Asthma
The Breathmobile Program: structure, implementation, and evolution of a large-scale, urban, pediatric asthma disease management program
Dis Manag
The Breathmobile Program: a good investment for underserved children with asthma
Ann Allergy Asthma Immunol
Expert panel report: guidelines for the diagnosis and management of asthma
Cited by (39)
Improved asthma outcomes among at-risk children in a pharmacist-led, interdisciplinary school-based health clinic: A pilot study of the CAReS program
2022, Journal of the American Pharmacists AssociationCitation Excerpt :Although beyond the scope of this study, further investigation to identify specific pharmacological knowledge items that present difficulty for the child/caregiver and how this affects asthma control and morbidity outcomes is recommended for future study. The achievement of asthma control in 88% of our patients by the third month of participation was on par with the estimate of 80% of patients who achieved well-controlled asthma by their third visit in a large study that involved 7822 patients across 34,339 visits.13 Postintervention morbidity in our pilot study trended down as expected based on postyear reductions reported in the study by Scott et al.13 The cohort of patients in their study who were similar in demographic and clinical composition to our pilot study resided in Chicago, IL and Baltimore, MD.
Boosting nitric oxide in stress and respiratory infection: Potential relevance for asthma and COVID-19
2021, Brain, Behavior, and Immunity - HealthUse of National Asthma Guidelines by Allergists and Pulmonologists: A National Survey
2020, Journal of Allergy and Clinical Immunology: In PracticeRacial disparities in asthma-related health care use in the National Heart, Lung, and Blood Institute's Severe Asthma Research Program
2019, Journal of Allergy and Clinical ImmunologyCan asthma be well controlled with NAEPP guideline care in morbidly obese children? The Breathmobile
2019, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :In addition, no significant differences were found in baseline FEV1%, FVC%, or FEF25%-75% predicted or number of controller medications required between these 2 cohorts. In a more recent study, Scott and colleagues, using multi-site BM data of more than 8,000 patients, including our site, found in children with persistent mild to moderate asthma that factors contributing to maintaining well-controlled asthma included medication adherence, visit interval (<90 vs >90 days), age, race, health insurance, and BMI.30 In our study, we extended the classification of BMI and found that routine follow-up care was of critical importance in achieving well-controlled disease, particularly in MOB children with asthma.
Changes in asthma self-management knowledge in inner city adolescents following developmentally sensitive self-management training
2018, Patient Education and Counseling
Support for analysis of data was provided by the Asthma and Allergy Foundation of America, California Chapter.
Disclosure of potential conflict of interest: C. A. Jones is on the Merck US Respiratory Advisory Board. The rest of the authors have declared that they have no conflict of interest.