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P EDIATRIC S UCLA Breathmobile Engages Schools and Communities New Approach to Treating Children’s Asthma Asthma is a chronic lung disease that, in young children, is often triggered by the common cold or other respiratory-tract infections. Traditionally, children with mild- to-moderate asthma are often prescribed anti-inflammatory drugs that must be taken orally or through an inhaler daily for several weeks or months to reduce asthma-related problems. For some of these children, a new treatment regimen may effectively control their asthma symptoms in less time. “It’s not a new drug,” says Sande Okelo, MD, PhD, a pediatric pulmonologist at UCLA. “It’s a new way of using a traditional asthma medicine.” The medicine, budesonide, decreases the number and severity of asthma attacks by reducing swelling and mucus production in the airways. The standard approach is for patients to take a daily, low-dose regimen of the drug (0.5 mg nightly) over an extended period of time to prevent asthma flare-ups after the onset of cold symptoms. A recent study, however, demonstrated that a twice-daily regimen of 1 mg taken over seven days only at the time of a cold was equally effective at reducing symptoms in children younger than 5 years of age. “The majority of young children with asthma only have problems when they get a cold,” Dr. Okelo explains. “This new treatment approach may be very appealing to the parents of those youngsters because they will no longer have to keep up with giving their toddlers asthma medications every day for months on end.” Some parents may also prefer the new regimen because they are reluctant to give their children inhaled steroids or to expose them to any type of medication for extended periods of time, according to Dr. Okelo. He emphasizes, however, that oral and inhaled asthma medications are safe for children, even when taken long-term. The biggest disadvantage to the new treatment regimen, Dr. Okelo says, is that each dose is given through a nebulizer in the form of a mist inhaled into the lungs. This takes approximately 10 minutes to administer. “The challenge for parents will be to get their toddlers to sit still for 10 minutes, two times per day for seven days,” Dr. Okelo explains. “Still our goal is to continue to identify targeted strategies that resonate with different parents for different reasons so that it will be much easier to get them to follow an effective asthma treatment plan that works for their child.” Although there is no cure for asthma, it can be effectively managed with appropriate prevention and treatment. For students who attend one of approximately 25 schools in the Long Beach Uniﬁed School District, the Mattel Children’s Hospital UCLA Breathmobile often represents the only source of access to diagnosis, treatment, medication and education for asthma management. “Children with asthma do better when they have access to specialists,” says Maria Garcia Lloret, MD, a pediatric allergist and immunologist at Mattel Children’s Hospital UCLA. “Unfortunately, many low-income children don’t have access to asthma specialists and may also experience other barriers to care that are associated with poor outcomes.” Asthma is the leading cause of school absenteeism and a major cause of preventable emergency department visits and hospitalizations among children. The RV-style mobile asthma clinic travels to Long Beach three times each week to see students at highest risk for asthma-related problems. The team performs appropriate tests, ensures patients have access to necessary medications and provides self-care education serving more than 1,000 students annually. To watch a video about the UCLA Breathmobile, go to: community. medschool.ucla.edu/ breathmobile Join Dr. Sande Okelo for an asthma webinar, July 30, 2014, at 11:30 am. To register, go to: uclahealth.org/asthmawebinar Vital Signs Summer 2014 Vol. 63 11