Effect of the Telemedicine Enhanced Asthma Management-Uniting Providers (TEAM-UP) Program on Asthma Outcomes: A Randomized Clinical Trial

Department

Allergy and Immunology

Document Type

Article

Publication Title

The Journal of Pediatrics

Abstract

Objective: To evaluate a school-based intervention for children with moderate-severe persistent/poorly controlled asthma, adding telemedicine consultations with specialists to school-based directly observed therapy of preventive asthma medications in order to optimize management.

Study design: From 2018 to 2024 children aged 4-12 years with moderate-severe/poorly controlled asthma were randomized to Telemedicine Enhanced Asthma Management-Uniting Providers (TEAM-UP) or enhanced usual care. TEAM-UP included daily school-based directly observed therapy and telemedicine visits with asthma specialists. The primary outcome was mean symptom-free days/2 weeks. Analyses used linear mixed and generalized estimating equation models.

Results: We enrolled 326 children (62% participation; mean age 8.4 years; 60% male; 58% Black; 35% Hispanic; 80% Medicaid). The majority (84%) of TEAM-UP participants had ≥ 1 specialist visit and 74% received school-based DOT (excluding the pandemic). We found that children in TEAM-UP vs enhanced usual care had more symptom-free days (mean difference: 1.32; 95% CI 0.58-2.05) and were less likely to miss school (odds ratio: 0.70; 95% CI 0.52-0.96) or require emergency department visits or hospitalizations for asthma (odds ratio: 0.54; 95% CI 0.31-0.96).

Conclusions: TEAM-UP significantly improved asthma symptoms and reduced health care use, offering a promising model for asthma care in underserved communities.

Trial registration: ClinicalTrials.gov number: NCT03545906 https://clinicaltrials.gov/study/NCT03545906?term=NCT03545906&rank=1.

First Page

114872

DOI

10.1016/j.jpeds.2025.114872

Volume

289

Publication Date

2-1-2026

Publisher

Mosby

Medical Subject Headings

Humans; Asthma; Male; Telemedicine; Child; Female; Child, Preschool; School Health Services; Anti-Asthmatic Agents; Treatment Outcome

PubMed ID

41139012

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