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Health workers improve adherence in urban children with asthma

Published: September 1, 2022

Asthma is common yet many children with asthma do not receive recommended clinical care. This, and other factors, often result in poorly controlled asthma. Inhaled corticosteroid medications are a well-known treatment that improves asthma control, but knowing how to use these medicines correctly and remembering to use them every day can be difficult. Unfortunately, many people do not use inhaled corticosteroids as recommended. Community health workers (CHWs) are lay people with health training who help families understand asthma and how to treat it, including how and when to use asthma medications.

Pappalardo, et. al.’s recent article in The Journal of Allergy and Clinical Immunology: In Practice describes the Asthma Action at Erie Trial. This comparative effectiveness trial recruited 223 children with uncontrolled asthma from 5 to 16 years old and randomized them to a CHW or a certified asthma educator (AE-C) intervention to study the intervention effects on medication adherence, inhaler technique, physical activity, and asthma control.

At the start of the study, only 44% of children with uncontrolled asthma had an inhaled corticosteroid medication in their home. After one year of intervention, more children in the CHW group had these medications (56%) than children in the AE-C group (35%), they were more than twice as likely to have these important asthma medications physically present at their home and to use their medications more often. These improvements were lost when the intervention ended. Medication inhaler technique for children receiving the CHW intervention significantly improved at 6-months and remained improved even when CHW intervention ended.

Community Health Workers were associated with improved inhaler technique and with increased availability and use of inhaled corticosteroid medications in the home in high-risk urban children with asthma.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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