Written by Hannah Harp
Spoon Feed
Specialty asthma care provided to school children via a hybrid telemedicine/school-based clinic model was feasible and effective for improving asthma control.
Accessible asthma care, a breath of fresh air
Asthma is common, complex, and potentially life-threatening, and it requires thorough patient education, proper medication, and frequent follow-up for adequate management. Resources for a family dealing with complicated asthma are generally out of reach for most high-volume primary care offices; however, specialist visits can be more difficult to get to due to time or transportation constraints.
This study evaluated the effectiveness of school-based telehealth asthma clinics in underserved communities. Using a retrospective design, it analyzed data from 54 patients (mean age = 12.23 years) who received at least one telehealth consultation with a pediatric pulmonologist. Asthma control significantly improved (mean delta ACT score = +2.45, p = 0.017, Cohen’s d = 0.58), with 30% transitioning from poorly controlled to well-controlled asthma. Healthcare utilization declined, including emergency department visits and hospitalizations, highlighting the potential for telehealth to improve pediatric asthma outcomes in marginalized populations. The study was small and seemed to rely on only one respiratory therapist to coordinate the program; some hospitals may not have resources to do this. There is also a fair amount of data that doesn’t show up in the EHR and thus was unaccounted for, including attempted treatments with primary care physicians, outside hospital visits, and pharmacy info. The discussion nicely outlines these limitations and how future studies can take them into account.
How will this change my practice?
This pilot program is an incredible example of how telemedicine and school-based health centers can work together to create more accessible care for underserved populations. There are mobile asthma clinics in my area that provide similar specialty care at schools – the major drawback with these clinics is that our EHRs do not integrate, so we don’t have access to evaluations or treatment plans. For a disease as complicated as asthma, consistent information sharing would make a huge difference in providing consistent treatment. Universal EHR, anyone?
Source
Outcomes and Recommendations From Telehealth Asthma Clinics in Underserved Schools. Pediatr Pulmonol. 2025 Feb;60(2):e71003. doi: 10.1002/ppul.71003. PMID: 39960311
