Stock inhaler program in Chicago schools lowers asthma-related disturbances
Key takeaways:
- During the 2023-2024 school year, the number of Chicago public schools adopting a stock inhaler program grew from four to 306.
- In this timeframe, 124 stock inhaler events took place.
SAN DIEGO — In Chicago public schools that adopted a stock inhaler program, more students who used a stock inhaler for asthma symptoms went back to class vs. leaving with a parent or emergency services, according to a poster presented here.
This mixed methods pilot study was presented at the 2025 American Academy of Allergy, Asthma and Immunology/World Allergy Organization Joint Congress.
“The impact of public health programming within communities and schools that work to increase access to school-based asthma management or resources to de-escalate respiratory distress are critical,” Andrea Pappalardo, MD, FAAAAI, FACAAI, associate professor of medicine and pediatrics at University of Illinois College of Medicine and allergy service director in the division of pulmonary, critical care, sleep and allergy, told Healio.
“These programs not only facilitate in the moment [of] asthma symptoms but give you concrete details as to what happened during school incidents to work from when you have children follow-up for more intense asthma management,” Pappalardo, who is a member of the Healio Women in Allergy Peer Perspective Board as well, said.
According to Pappalardo, this study also stresses the importance of action on the clinician side.
“[It] is imperative we respond as clinicians to requests from schools to fill out the Asthma Action Plan and any other supporting documentation necessary, including a personal inhaler prescription for schools, when needed,” Pappalardo said.
In this study, Pappalardo and colleagues examined four public schools in Chicago (n = 6,023; 48.4% Black/African American; 39.7% Hispanic/“Latinx”; 8% white) during the 2023 to 2024 school year, all with high prevalences of asthma, to determine how feasible a stock inhaler program would be, as well as how it would impact/benefit the students with asthma in these schools.
Notably, researchers used two different frameworks in this analysis, one for design (the Exploration, Preparation, Implementation and Sustainment framework) and one for assessment (the Reach, Effectiveness, Adoption, Implementation and Maintenance framework).
Nurses within the pilot schools were asked to complete training for the stock inhaler program, and 100% fulfilled this task, according to the poster.
Over the course of the 2023 to 2024 school year, the poster highlighted that more schools adopted the program, including 95 schools in February and 207 schools in April.
“Because of the timing of state funding and the collaborations with RESCUE-IL and Respiratory Health Association and [the Asthma and Allergy Foundation of America], we were able to rapidly upscale in the school year 2023 to 2024 starting with four schools in September 2023 and ending in June 2024 with 306 schools [n = 160,181],” Pappalardo told Healio.
Further, 316 more schools adopted the program in fall 2024, according to the study.
“Now, we have over 600 public schools in Chicago participating in the RESCUE-IL program, which is a statewide program for stock inhalers,” Pappalardo said.
In terms of use of the program during the assessed school year, researchers reported that 124 stock inhaler events took place, with most due to asthma symptoms vs. in prevention (120 events vs. four events).
According to the poster, a higher proportion of students who used a stock inhaler for asthma symptoms went back to class vs. leaving with a parent or leaving with emergency medical services (66.9% vs. 23.3% and 7.5%).
When seeking out how many stock inhaler incidents adhered to the Chicago Public Schools dosing protocol, researchers found this outcome in over half (61.3%) of the incidents.
Receiving fewer puffs than recommended occurred more frequently in severe vs. mild-moderate stock inhaler cases (90.9% vs. 31.9%), according to the poster.
“Schools see a lot of asthma symptomatology every day in our patients. We must consider them as an extension of our health care system and an invaluable resource to help our children get the best care they deserve for their asthma,” Pappalardo told Healio.
“Future studies will be able to do significant amount of preparation planning work to ensure that when able and appropriate, a rapid upscale of programming could be possible,” Pappalardo added.
For more information:
Andrea Pappalardo, MD, FAAAAI, FACAAI, can be reached at apappa2@uic.edu.