Randomized trial of the feasibility of ED-initiated school-based asthma medication supervision (ED-SAMS)

Lynn B. Gerald, Joe K. Gerald, John M. VanBuren, Ashley Lowe, Cecilia C. Guthrie, Eileen J. Klein, Andrea Morrison, Emily Startup, Kurt Denninghoff

Research output: Contribution to journalArticlepeer-review


Background: While using an inhaled corticosteroid (ICS) in the weeks after an ED visit reduces repeat visits, few children receive a needed prescription. Because a prescription may not be filled or used, dispensing ICS at discharge and supervising its use at school could overcome both barriers until follow-up care is established. To assess the feasibility of such an intervention, we conducted a pilot study among elementary-age school children with persistent asthma who were discharged from the ED following an asthma exacerbation. Methods: Eligible children were randomly assigned to ED-dispensing of ICS with home supervision or ED-dispensing of ICS with home and school supervision. The primary outcomes were ability to recruit and retain participants, ability to initiate school-supervised medication administration within 5 days of discharge, and participant satisfaction. Results: Despite identifying 437 potentially eligible children, only 13 (3%) were enrolled with 6 being randomized to the intervention group and 7 to the control group. Eleven (85%) randomized participants completed the 90-day interview (primary outcome) and 8 (62%) completed the 120-day interview (safety endpoint). Four (67%) intervention participants started their school regimen within 5 business days and 2 started within 6 business days. Conclusion: While our pilot study did not meet its recruitment goal, it did achieve its primary purpose of assessing feasibility before undertaking a larger, more intensive study. Several major recruitment barriers need to be mitigated before EDs can successfully partner with schools to establish supervised ICS treatment. Trial registration: ClinicalTrials.gov, NCT03952286. Registered 16 May 2019.

Original languageEnglish (US)
Article number179
JournalPilot and Feasibility Studies
Issue number1
StatePublished - Dec 2021


  • Asthma
  • Pediatric
  • Pediatric emergency medicine
  • Schools

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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