Improved asthma outcomes among at-risk children in a pharmacist-led, interdisciplinary school-based health clinic: a pilot study of the CAReS program

ABSTRACT Background Disparities in access to care and outcomes have been identified among children with asthma living in underserved communities. The CAReS program was established to reduce disparities by providing school-based, comprehensive asthma care by a pharmacist-led, interdisciplinary team to high-risk pediatric populations in the Greater Pittsburgh area. Objective To investigate program impact on follow-up appointment attendance, the delivery of guideline-based care, asthma control, asthma morbidity (ED visits, OCS requirement), and asthma-related knowledge and quality of life. Methods The study enrolled 50 children with asthma from six elementary schools from September 2014 to December 2017. Children completed five visits over a three-month period. McNemar's test assessed improvement in guideline-based controller therapy usage and reduced morbidity (ED visits or OCS requirement). GEE analyses determined significance of monthly improvements in asthma control, asthma knowledge, and quality of life. Results A 100% show rate was achieved in nearly all participants (92.0%). The majority of patients were African-American (56%), reported lifetime exposure to ETS (56%), and had elevated BMI (53.1%). In children with persistent disease, only 21.4% were prescribed controller therapy at baseline which improved to 78.5% upon enrollment (p Conclusions Disparities in asthma outcomes due to inadequate access to healthcare can be addressed. Improved asthma control, asthma medication knowledge, quality of life, and reduced morbidity in high-risk pediatric patients is achievable as demonstrated by our study. Our findings support the feasibility and value of a pharmacist-led, interdisciplinary school-based health care delivery model in providing comprehensive asthma care to at-risk pediatric populations.