American Lung Association reports barriers to asthma medication access in schools

A recent report from the American Lung Association noted several barriers to asthma care in U.S. schools, including the inability of students to self-carry an asthma inhaler, availability of back-up medication and lack of access to a school nurse during the school day.

“For a child who is struggling to breathe, the trip from the classroom or playground to the school health room for medication can be perilously far,” Barbara Kaplan, MPH, CHES, national director of lung health education at the American Lung Association, said in a press release. “The greatest danger is for elementary school students who are not always prepared to identify symptoms and might be caught off guard as the symptoms escalate. It’s essential for kids to have quick, reliable access to asthma medications, including in schools.”

In 2014, the American Lung Association distributed an assessment tool to school personnel to assess the perceptions among staff regarding asthma medication policies, in addition to concrete practices at the school and district level. An analysis of the results of this assessment revealed several issues preventing optimal access to asthma medications in schools, including assessing student readiness to self-carry and availability of back-up medication.

Since not all school-aged children are developmentally prepared to evaluate their symptoms and use their inhalers properly in the case of an emergency, some state laws require the student’s health care provider to certify that the child is capable, while others require an assessment from the school nurse. Although many schools have established blanket policies that elementary aged students were not allowed to self-carry, 80% of responders noted that students older than 8 years should be allowed if they are developmentally mature.

Additionally, the majority of school personnel noted that available back-up medication – in the event that a student permitted to self-carry either forgets or loses their medication – is a crucial requirement for school health services. However, acquiring additional inhalers can be problematic for families as insurance companies often cover one inhaler with supplementary inhalers paid for out of pocket, as well as additional visits to their health care provider for the secondary prescription.

“No child should have to suffer through severe asthma symptoms without the appropriate medications or treatment plan in place,” Kaplan said in the release. “Asthma is a manageable disease, and those living with asthma can live a healthy and active life by avoiding or limiting their exposure to environmental asthma triggers at home and school and having medications available and an asthma action plan in place so they know what to do when symptoms start and what to do in an emergency.”

The American Lung Association offers the following recommendations for action to aid children, families and school personnel in managing asthma among students:

State and local officials must educate all school personnel on existing laws and policies, and clarify expectations for their implementation;
Schools, asthma advocates and health care providers must facilitate parent and caregiver engagement in the management of their child’s asthma at school;
School districts must implement standardized protocols and instruments for the assessment of a student’s readiness to self-carry; and
Schools must provide access to back-up medication using standing orders for quick-relief medication.

“Just as it takes a village to raise a child, it takes a community to support every child with asthma, from school administrators, teachers and nurses to soccer coaches, music teachers and peers,” Kaplan said. “Don’t wait for an asthma emergency to take action, learn what you can do to help kids with asthma manage the disease so they can focus on learning and achieving their full potential.”– by Savannah Demko