Mobile clinic improved asthma outcomes among low-income children

ATLANTA — For low–income patients with asthma without regular access to health care, direct care via mobile clinics significantly improved asthma outcomes, according to research presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

In 2009, the University of California, Los Angeles, launched their Breathmobile program, intended to provide care to children at their schools in Long Beach, California, an area in which 33% of pediatric patients live in poverty.

“The UCLA Breathmobile was essentially an asthma clinic on wheels that operated in Long Beach, CA, a city where many children live in poverty,” Connie H. Lin, MD, from the University of California, Los Angeles, told Infectious Diseases in Children. “Staffed by an asthma specialist, a nurse/educator and a respiratory therapist, the UCLA Breathmobile provided free, guideline-based asthma care to children at their school sites.”

While the overall prevalence of asthma in Los Angeles County is 8% among pediatric patients, 15% of children in the Long Beach area exhibit asthma symptoms. The Breathmobile offered free and direct care from a physician, a registered nurse and a patient-service worker.

To determine whether this initiative improved asthma outcomes among students, the researchers examined the number of emergency room visits, hospitalizations and school absenteeism due to asthma, and evaluated patient control of symptoms at follow-up visits. The care provided by with the Breathmobile was based on the 2007 guidelines from the National Asthma Education and Prevention Program and National Heart, Lung, and Blood Institute, and the presented asthma symptoms were evaluated at baseline and follow-up visits with the providers.

The mobile clinic served 565 pediatric patients spanning over 1,117 visits from Oct. 2011 to Sept. 2013. Out of those patients, 80% (454) had received an asthma diagnosis with ranging severities at baseline visit (34% intermittent, 32% mild, 24% moderate and 9% severe). When comparing the pre- and post-period assessments, the researcher found that the number of emergency room visits decreased from 39.8% to 21.4%, and hospitalizations decreased from 9.2% to 4.1%.

Additionally, the number of children missing more than five days of school due to asthma decreased from 33.7% to 11.2%. When examining follow-up visits, researchers identified that a majority (65%) of patients had their symptoms well-controlled at their last visit, while 22% were not well-controlled and 12% were poorly controlled.

“This 2-year long intervention resulted in a significant reduction in ER visits, school absenteeism and hospitalizations,” Lin said. “We hope that our findings motivate others to implement similar modes of onsite care in communities where children may lack access, as this approach clearly decreases asthma morbidity in vulnerable populations.” –by Katherine Bortz

Reference: Lin CH, et al. Abstract 312. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 3-6, 2017; Atlanta.

Disclosure: The researchers report no relevant financial disclosures.