TOPLINE:

The Telemedicine Enhanced Asthma Management-Uniting Providers (TEAM-UP) program, which involved preventive medication for asthma and telemedicine visits with specialists, increased the number of symptom-free days and reduced school absenteeism in children with moderate-to-severe asthma. The program also showed promise in reducing emergency visits and hospitalizations.

METHODOLOGY:

• Researchers conducted a prospective randomized trial from 2018 to 2024 involving 325 children (mean age, 8.4 years; 60% boys; 58% Black) with moderate-to-severe asthma identified through referrals from elementary schools or primary care or specialist practices.
• Children were randomly assigned either to the TEAM-UP program (n = 162) or to receive enhanced usual care (n = 163). Directly observed therapy in schools was recommended for all children.
• Children in the TEAM-UP program received one dose of preventive medication for asthma daily under supervision at school, with additional doses given at home as needed, and telemedicine visits with asthma specialists with assistance from school nurses. Enhanced usual care included recommendations for directly observed therapy and specialist referrals but did not facilitate telemedicine visits.
• The primary outcome was the mean number of symptom-free days over 2 weeks (days on which the child did not have coughing, wheezing, shortness of breath, or need for rescue medicine for 24 hours). These were assessed at 3, 5, 7, and 12 months after baseline, tracked using symptom diaries.
• Other outcome measures included school absenteeism and healthcare utilization due to asthma.

TAKEAWAY:

• Children in the TEAM-UP program had more symptom-free days than those receiving enhanced usual care, with a mean difference of 1.32 days (P < .001).
• Children in the TEAM-UP group vs enhanced usual care group experienced fewer days with symptoms (3.4 vs 4.1 days) and fewer nights with symptoms (1.6 vs 2.3 nights).
• By 12 months, children in the TEAM-UP group had decreased odds of missing school and requiring emergency visits or hospitalizations due to asthma (odds ratio [OR], 0.70; 95% CI, 0.52-0.96) and (OR, 0.54; 95% CI, 0.31-0.96), respectively.
• Higher percentages of children in the TEAM-UP group were reported to have used preventive medication for 2 weeks and mild or well-controlled asthma symptoms than children in the enhanced usual care group. Most caregivers believed the program benefited their child and reported they would join again.

IN PRACTICE:

“This program could serve as a model for the care of children with asthma in communities that are under-resourced,” the authors wrote.

SOURCE:

The study was led by Jill S. Halterman, MD, MPH, of the University of Rochester School of Medicine and Dentistry in Rochester, New York. It was published online on October 23, 2025, in The Journal of Pediatrics.

LIMITATIONS:

The study was conducted in a single urban school district. The reliance on an existing school-based telemedicine program may limit the applicability of the intervention in other settings. Caregiver-reported outcomes may introduce potential recall bias.

DISCLOSURES:

The study did not report receiving any funding. Various authors disclosed receiving speaking, lecture fees, and grants from various pharmaceutical companies, including GSK, Sanofi, and Takeda. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.