Demographics and outcomes of a school-based breathmobile program in Orange County, CA

Abstract

Rationale The Breathmobile® program was developed to improve children's health status and quality of life by providing specialty care to asthmatic children at their local schools. The demographics and outcomes of a program specially designed to treat inner-city asthmatic children in Orange County, CA have never been reported. Methods Since April 2002, more than 235 children were evaluated for asthma by the Breathmobile®. Analysis included evaluation of medical history, physical exam, spirometry testing, skin testing, and physician diagnosis of asthma according to the NHLBI guidelines. Results Analysis of 235 asthmatic patients showed a population of 57% males/43% females, mean age of 8 years, and 75% Hispanic/Latino. Of these asthmatics, 30% had intermittent and 70% persistent disease. Skin testing showed the highest sensitivity rate to dust mite (23% in intermittent and 31% in persistent asthma), with cockroach second (13% in intermittent and 13% in persistent asthma). Of these children in the past year, 54% had missed school due to asthma symptoms (13% having missed more than 10 days), 27% had visited the ER (15% more than two times), and 10% had been hospitalized. On initial evaluation, 29% of asthmatics were on controller medications, which increased to 70% by the first follow-up visit. Asthma symptoms (cough, chest tightness, wheezing, dyspnea, and awakenings) decreased from four to one in persistent asthmatics by the first follow-up visit (average 35 days), with ER visits declining to 2%. Conclusions The Breathmobile® provides valuable access and improved outcomes in the care of inner-city asthmatic children.