Asthma Programs Fall Flat in Baltimore

Pediatric asthma symptoms not improved with mobile clinics and home education programs

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The pediatric asthma of minorities and low-income families is often under-treated. Despite best efforts, two Baltimore initiatives have not helped improve that situation.

A recent study showed that mobile clinics and home educational programs did not improve pediatric asthma symptoms in minority and low-income families. Any positive results were short-lived. More educational efforts may be needed to highlight the importance of non-emergency management of pediatric asthma.

"Have your child tested for asthma by a family physician."

The study, conducted by the Johns Hopkins Children’s Center, involved 321 children with asthma, aged two to six, who came from low-income families in Baltimore over the course of one year. The children were then separated into four different groups.

One group received mobile clinic support, another group received home education support, the third group received a combined support effort using the two programs and the last group did not receive any support.

According to the study, pediatric asthma affects over six and a half million children in America. Minority children and children from low-income families tend to have worse symptoms, more flare-ups and less than optimal asthma management.

The mobile clinic, called the Breathmobile provided exams and prescription medication to help manage their asthma. Schedules and reminders were sent out to the families. Despite it being free and conveniently located, less than half of the families made an appointment and only 20 percent showed up for the appointment.

The results were not better for families with home education support. The group with the combined Breathmobile and home education only had an extra 1.7 days, in a month, of being symptom-free compared to children who did not receive any support.

This small improvement did not last for more than six months. Hospitalizations were down 83 percent in the combined group but, again, that did not last through the year.

There was no significant difference between the four groups in regards to emergency room visits, quick-acting medication, such as inhalers, or quality of life. Possible explanations for the poor performances by the programs include daytime schedules that could not work due to parents working, or misunderstanding the importance of non-emergency treatment.

While these two programs were unsuccessful, future studies can turn that around. New studies can examine possible ways to educate families on the importance of non-emergency management of asthma.

The Breathmobile can have extended hours or scheduled appointments on the weekend. Educational programs can be set up in school or community centers to increase awareness. 

This study was published in the November edition of the Journal of Allergy and Clinical Immunology.

Reviewed by: 
Review Date: 
November 29, 2011
Last Updated:
December 4, 2011