Wanda Phipatanakul, MD, MS: Reducing Disparities in School-Based Asthma Programs

In recent years, pediatric asthma care has evolved considerably due to improvements in school-based asthma care, some of which were inspired by the challenges of the COVID-19 pandemic.

Despite these improvements in school-based asthma care, introducing these programs to communites in need can prove challenging.

In an interview with HCPLive, Wanda Phipatanakul, MD, MS, Division of Immunology at Boston Children's Hospital, spoke of how the adoption of these programs could reduce health dispraties.

Her work will be presented at the 2022 American Academy of Allergy, Asthma & Immunology Annual Meeting (AAAAI) in Phoenix during the session, "Lessons Learned for School-Based Asthma Care During COVID-19".

“Prior to the pandemic, there have been a lot of efforts focused on school-based asthma management,” Phipatanakul said. “One of the reasons is that kids spend a lot of time in school, so getting them their medications and improving their adherence is a significant challenge. There is also a lot of disparities in asthma, so going,centrally, where a child already is can be really beneficial.”

Though these asthma programs are difficult to implement since they require community buy in and support from the schools themselves, Phipatanakul had engaged in efforts to establish global standardized school-based asthma management programs including SAMPRO as recently as 2016.

She noted that these programs allowed for easy communication among nurses, physicians, and families regarding their child’s asthma or allergies, and reduced disparities in communities that might have had limited access to healthcare resources prior to these programs.

These programs were halted at the beginning of the COVID-19 pandemic, and though that did provide challenges regarding access to pediatric asthma care, the adoption of telemedicine helped continue patient care. Many schools across the country have since reopened, but the influence of telemedicine has remained.

“There's been more discussion of consideration of telemedicine programs in schools,” she said. “Telemedicine really took off with the pandemic, and can you imagine having telemedicine in a school would be a fantastic opportunity to try to help kids, because then you kind of bring the health care over to the school as well. As far as asthma care during COVID-19, we've learned that asthma is not a severe risk factor for severe COVID-19, which is a positive, and that COVID-19 does not increase asthma exacerbations or emergency room visits.”

Phipatanakul added that telemedicine was “here to stay”,and has been shown to enhance asthma management and decrease the number of children missing school due to clinical visits. However, the challenge of providing telemedicine-based programs and other resources to communities in need has remained a key issue.

“There are barriers including different resource and equitable resource allocations; barriers include access and stakeholder involvement to really maintain viability and getting enough resources and funding,” Phipatanakul said. “There is now legislation that is trying to shift some some of the resources to programs and schools that value and have initiatives to help this. Environmental triggers is an area where you could make a tremendous impact. The kids are sitting in school all day, it's their required occupation and if you can improve their environment, that's really critical.”

To hear more from Dr. Phipatanakul on how school-based asthma programs improve upon disparities in healthcare, watch the full interview above.