Strengthen Your School-Based Asthma Management Program

If you answer “yes” to either of these questions, then you’ll want to take a look at your school-based asthma management program or work with schools in your community to see if it’s doing all it can to improve academic performance and increase funding.

Without a strong school-based asthma management program, students with asthma can miss significantly more school and perform worse than students without asthma.  This can also impact the community, as parents miss work to stay home with their children. When students’ asthma is under good control, they can attend school and perform equally well.  Increased attendance increases funding for most school districts. 

A strong school-based asthma management program is usually part of the system used by a school and school district to assist students with any type of chronic condition.  These systems are guided by school health councils or wellness teams and reflect a partnership between school staff, student, parents, and asthma care clinicians.  For any chronic condition the school proactively identifies students and obtains a care plan (Asthma Action Plan) for each student with asthma.  Prevention activities and education for staff, students and families are important components, too.

For students with asthma, many prevention activities are undertaken by the school’s Indoor Air Quality Team in order to reduce or eliminate asthma triggers.   These activities cannot be expected to eliminate all asthma episodes so immediate care must also be available.  Although older students are usually encouraged to carry quick-relief medicine and manage their own episodes, most students don’t consistently have their medicine at all times.  School nurses can reduce the severity of episodes, and maybe even save a life, when they have a stock supply of albuterol and standing orders/protocols to assist any student having a severe asthma episode.  Stock albuterol and standing orders are especially important when a personal Asthma Action Plan has not been completed for a student.   Suggested emergency protocols have been developed by the National Asthma Education and Prevention Program (http://www.ashaweb.org/i4a/pages/index.cfm?pageid=3420).

Similar to diabetes and other chronic conditions, asthma management is all about achieving and maintaining good control.  In order to control their asthma, students need to monitor their air flow and many need to take preventive medicine before physical activity.  Schools that provide a peak flow meter (ideally an electronic one that measures FEV1) help to promote self-management and good asthma control.

A final key component is a system for monitoring, evaluating, and improving policies, programs and services.  Schools that actively assess severe asthma episodes and their management can identify area for improvement that can result in healthier students who are ready to learn.
Reach out to the schools in your community to see if their school-based asthma management programs are providing the best support available to students with asthma.  More information on managing asthma at school is available at: http://www.ashaweb.org/i4a/pages/index.cfm?pageid=3420.

Dr. Lani Wheeler, MD, FAAP, FASHA, a Senior Scientist with The Cadmus Group, Inc., is a public health pediatrician and consultant in environmental health, especially school-based asthma management programs. She recently co-chaired the NHLBI National Asthma Education and Prevention Program’s (NAEPP) School Education Subcommittee where she represented the American School Health Association (ASHA).