School-Based Asthma Therapy Improved Children’s Asthma Control, Reduced HCRU

A school-based asthma therapy (SBAT) program yielded improvements in asthma control in children aged 5 to 19 and may benefit children with asthma in a wider setting.1

“We help families get better adherence to kids’ asthma control medication regimens by having the school nurses give them their meds on the days that they go to school,” lead investigator Kimberly Arcoleo, PhD, professor at the Michigan State University College of Nursing, said in a statement.2

Arcoleo and colleagues reviewed 6-year retrospective medical records for 1 year before and 1 year after SBAT enrollment for children from 2 metropolitan school districts that received care at Nationwide Children’s Hospital (NCH). They assessed Asthma Control Test (ACT) and health care provider (HCP) ratings and also collected asthma-related health care utilization data, including emergency department (ED), urgent care, and acute care visits; hospitalizations; and pediatric intensive care unit (PICU) admissions.

“Students get 2 inhalers with controller medication,” Arcoleo added.2 “One that goes to school and one that stays home so it doesn’t have to move back and forth. The school nurse administers the medication to the kids each school day according to their health care provider’s instructions. Some kids need it once a day, some need it twice a day.”

The investigators found thatin 633 participants assessed, ACT increased by 37% and HCP increased by 56% (both P <.0001). Furthermore, asthma-related ED visits decreased by 49%, hospitalizations by 50%, PICU admissions by 71%, urgent care visits by 41%, and acute care visits by 38% (all P <.0001).

“Preliminary analyses show that although the program starts out costing about $3,000 per student annually, the cost drops down to only $500 once the school has their program established,” Arcoleo said.2

Looking at specific demographics, they also found that Black children had ACT increases of 40%and HCP increases of 66%in well-controlled asthma, with a 42% reduction in ED and urgent care visits, a 52% reduction in acute care visits, a 49%reduction in hospitalizations, and a 67% reduction in PICU admissions. Similarly, Latino children had ACT increases of 55% and HCP increases of 33%, with a 62% reduction in ED, 81% reduction in urgent care, and 50% reduction in acute care visits, as well as a 40% reduction in hospitalizations and 100% reduction in PICU admissions.1 

“For the elementary school kids, we decreased their missed instructional time by 16%,” Arcoleo said.2 “And for the kids in middle school and high school, we decreased their missed instructional time by 25%. Also, behavioral incidents, such as disruptive behavior, fighting and vandalism were reduced by 7%... This is important from the standpoint of learning. It’s also important for the schools because they get reimbursed by the federal government for attendance. It’s a double benefit.”

Arcoleo and colleagues noted inherent limitations of the study, including its nature as a retrospective record review that only spans 2 school districts and NCH records without considering possible external health care encounters. They also noted that the small subgroup analyses limited statistical power.1

REFERENCES

1. Arcoleo K, McGovern C, Allen E, et al. School-based asthma therapy: Improving medication adherence, asthma control, and health care utilization. J. Allergy Clin. Immunol. 2025; 4(2): 100428. doi: 10.1016/j.jacig.2025.100428

2. MSU research: School-based asthma therapy improves student health, lowers medical costs. News release. MSU. April 10, 2025. https://msutoday.msu.edu/news/2025/school-based-asthma-therapy-improves-student-health-lowers-medical-costs