BREATHE- Baltimore Realizing Equity in Asthma Treatment, Healthcare & Education- is a project that aims to shift the national norms on what asthma care in schools should include.

Historically, school nurses store an albuterol (rescue) inhaler for each of their students with asthma. This allows them to respond to exacerbations that are easy to control, but sometimes it isn’t enough.

If the albuterol doesn’t relieve the wheezing, students often have to go to the emergency room for additional care. Asthma exacerbations are among the most common reasons school nurses call 911 and kids miss school.

Inhaler Types

Rescue inhaler

ALBUTEROL

Used when you’re in exacerbation- wheezing, coughing, short of breath

EVERY kid with asthma needs one

Controller inhaler

Flovent, QVAR, Pulmicort, among many others

Used EVERY DAY to control symptoms

Only SOME kids with persistent asthma need one

For many kids with asthma, relying on albuterol inhalers isn’t enough. About ¼ of kids with asthma require an everyday medication called a controller inhaler. When taken properly, the controller inhaler keeps symptoms manageable and reduces reliance on albuterol. But getting and giving the controller inhaler at home is a challenge for some families….
Pediatrician Dr. Jill Halterman studied the method of directly observed therapy, or taking medicine with someone watching, in children with poorly controlled asthma. We took Dr. Jill Halterman’s model and put it into action in West Baltimore. School health staff administer controller inhalers to students who need them every school day, and families observe on the weekends.

It’s a simple intervention, with powerful results. For kids in the directly observed therapy (DOT) program had reductions in both their use of albuterol and school absences….