School-supervised use of a once-daily inhaled corticosteroid regimen: A cluster randomized trial
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Gerald JK 2018 SAMS R3 Main Text ...
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Final Accepted Manuscript
Author
Gerald, Joe KFisher, Julia M
Brown, Mark A
Clemens, Conrad J
Moore, Melissa A
Carvajal, Scott C
Bryson, Donna
Stefan, Nikki
Billheimer, Dean
Gerald, Lynn B
Affiliation
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Community Environm & PolicyUniv Arizona, Asthma & Airways Dis Res Ctr
Univ Arizona, BIO5 Inst
Univ Arizona, Coll Med, Dept Pediat
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Hlth Promot Sci
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Epidemiol & Biostat
Issue Date
2019-02-01Keywords
Schoolsanti-inflammatory agent
asthma
child
cluster randomized trial
directly observed therapy
inhaled corticosteroid
medication adherence
randomized controlled trial
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MOSBY-ELSEVIERCitation
Gerald, J. K., Fisher, J. M., Brown, M. A., Clemens, C. J., Moore, M. A., Carvajal, S. C., ... & Gerald, L. B. (2019). School-supervised use of a once-daily inhaled corticosteroid regimen: A cluster randomized trial. Journal of Allergy and Clinical Immunology, 143(2), 755-764.Rights
© 2018 American Academy of Allergy, Asthma & Immunology.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
School-supervised use of a once-daily inhaled corticosteroid regimen (supervised therapy) can improve medication adherence and asthma control. We sought to evaluate the effectiveness of supervised therapy in a unique setting and population. We conducted a cluster randomized trial of supervised therapy in 20 elementary schools with a disproportionate enrollment of low-income Latino students. Schools were purposively selected, matched, and randomized to receive 9 months of supervised therapy with mometasone furoate or usual care. All English- or Spanish-speaking students with self-reported asthma were eligible. The Asthma Control Questionnaire (ACQ) was interviewer administered quarterly at school. Students in supervised therapy schools were hypothesized to have lower ACQ scores than students in usual-care schools. Of 393 enrolled students, 189 students receiving immediate intervention and 143 students receiving delayed intervention provided 1 or more ACQ data points, were between 6 and 10 years of age, and were included in the primary analysis. At baseline, 39% of students reported taking a controller medication, and 24% had well-controlled asthma. Eighty percent of students receiving immediate intervention were prescribed mometasone. Schools administered 98% of prescribed doses when students attended school. Absences, weekends, and holidays reduced calendar adherence to 53%. During the first year, the mean ACQ score for students receiving immediate and delayed intervention was 1.55 (95% CI, 1.41-1.70) and 1.64 (95% CI, 1.47-1.80), respectively. The estimated treatment effect was -0.08 (95% CI, -0.31 to 0.14).Note
12 month embargo; available online 14 August 2018.ISSN
1097-6825PubMed ID
30118728Version
Final accepted manuscriptSponsors
National Institutes of Health/National Heart, Lung, and Blood Institute [1R18HL110858-01A1]; Investigator-Initiated Studies Program of Merck Sharp&Dohme Corporation; Thayer Medical Corporationae974a485f413a2113503eed53cd6c53
10.1016/j.jaci.2018.06.048
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