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News — With proper management and registered nurses on campus, the school absenteeism rate for children with asthma can be reduced to that of non-asthmatic children, according to a new study published in the journal CHEST, the official publication of the American College of Chest Physicians. The study, conducted through the Baylor Martha Foster Lung Care Center at Baylor University Medical Center at Dallas and the Dallas Independent School District (DISD), found that the rate of absenteeism between children with and without asthma symptoms has improved such that they are nearly indistinguishable.

Lead author and medical director of the Baylor Lung Care Center Mark Millard, M.D., says the implications of the study are far-reaching.

"We all know the devastating effect of untreated asthma on both academic and athletic performance, but our data suggests that the tide has turned, and with proper supervision and management, the impact of asthma can be minimized," said Millard. "Parents should expect that their child with asthma should be able to compete with the same degree of success as non-asthmatic peers, with current asthma medications."

Asthma and Attendance

The study is a result of an extensive survey of students in 17 of the DISD's more than 200 schools. Students were studied with questionnaires and asthma challenge tests to definitively identify this common medical condition, and attendance rates of these students were compared with those of non-asthmatic students.

No statistical difference was discovered between attendance rates of the groups of asthmatic students identified with that of their classmates.

School Registered Nurses Play Critical Role

Baylor Dallas has been partnering with the DISD since 1991 to improve school-based monitoring of children with asthma. One of the hospital's first interventions was to provide peak flow meters for all DISD schools for monitoring and assessing the severity of asthma symptoms. Using Baylor's work with the DISD as a model, the American Association of Respiratory Care created the national Peak Performance USA program, which provided peak flow meters for every school in the country, upon request. Almost all of the schools in the DISD have registered nurses on campus, and Baylor has helped these nurses learn about new medications and therapies for controlling asthma. Millard says the supervision of the school nurses plays a critical role in decreasing absenteeism of children with asthma.

"Even children with more obvious symptoms that were identified by school RNs before the screening missed no more school than the others, suggesting that the nurses are properly identifying asthmatic children and working with parents and primary care providers in achieving good asthma control," he said.

Anna Hilton, R.N., who had been the nurse director of the asthma management program for the DISD prior to joining the Baylor team for this project agrees.

"Having RNs on campus to identify and help primary care providers to properly manage children with asthma makes all the difference between a child missing critical educational time and a child able to learn and participate," she said.

Keeping Kids in Class

Results of the study point to the value of school nurses in helping children control their asthma and stay in class.

"Any child in any school district can achieve good asthma control, if there is access to the right medications and oversight," said Millard. "A well-trained and empowered school registered nurse may be the best solution to deal with the problem of uncontrolled asthma in children."

Children With Asthma Miss More School: Fact or Fiction? Chest. 2009 Feb;135(2):303-6. Epub 2008 Oct 10.