Results of an asthma education program delivered via telemedicine in rural schools

Publication date: Available online 19 February 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Tamara T. Perry, Jill S. Halterman, Rita H. Brown, Chunqiao Luo, Shemeka M. Randle, Cassandra R. Hunter, Mallikarjuna Rettiganti
BackgroundAsthma morbidity is high among low-income children living in rural U.S. regions, yet few interventions have been designed to reduce asthma burden among rural populations.ObjectiveExamine the impact of a school-based asthma education program delivered via telemedicine among children living in an impoverished, rural region.MethodsWe conducted a cluster randomized trial with rural children, ages 7-14 years, comparing a school-based telemedicine asthma education intervention to usual care. The intervention provided comprehensive asthma education via telemedicine to participants and provided evidence-based treatment recommendations to primary care providers.ResultsOf the 393 enrolled children, median age was 9.6 years, 81% were African-American and 47% lived in households with <$14,999 annual income. At enrollment, 88% of children reported uncontrolled asthma symptoms. At the end of the intervention, there were no statistically significant differences in reported symptom free days (primary outcome) for either the intervention or usual care group. Participants in the intervention group reported significantly higher utilization of peak flow meters to monitor asthma and reported taking their asthma medications as prescribed more frequently when compared to the usual care group. There were no changes in other outcome measures including quality of life, self-efficacy, asthma knowledge, or lung function between groups.ConclusionAlthough there was some evidence of behavior change among intervention participants, these changes were inadequate to overcome the significant morbidity experienced by this highly symptomatic rural, impoverished population. Future interventions should be designed with a multifaceted approach that considers caregiver engagement, distance barriers and inadequate access to asthma providers in rural regions.



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