Many children with early signs of high-risk asthma wait two to three years before enrolling in a high-risk asthma clinic, according to a new study led by researchers at the Indiana University School of Medicine. The findings, published in the Journal of Allergy and Clinical Immunology: In Practice, emphasize the need for families and doctors to spot early asthma warning signs and use structured treatment approaches to better support children living with the chronic lung disease.
To understand if children with signs of high-risk asthma received specialized support early enough, and to determine whether specialized clinic care made a measurable difference, the researchers explored data from 229 children under 11 years old with moderate-to-severe asthma who were enrolled in a high-risk asthma clinic.
They found that clinic enrollment resulted in a 36% reduction in the odds of experiencing severe asthma attacks, meaning children had fewer asthma-related emergency department visits or hospitalizations.
“The most surprising finding is that the children at highest risk were not necessarily getting help sooner,” said Arthur Owora, PhD, associate professor of pediatrics at the IU School of Medicine and research scientist at the Regenstrief Institute, who led the study. “Many had warning signs very early — such as wheezing, eczema, allergies, bronchiolitis, pneumonia or a parent with asthma — but still experienced delays before reaching the high-risk clinic.”
Owora said these warning signs are often already documented in medical records, indicating healthcare providers could spot vulnerable children earlier and connect them with the right care before repeated emergency visits occur.
Children at high-risk clinics benefit from more frequent follow-ups, asthma education, help with medication use, social work and psychology support, and treatment optimization, including evaluation for advanced therapies when needed. Patients who started inhaler therapy within a year of their diagnosis seemed to experience the greatest benefit from high-risk asthma care.
“Our study points to a better way to care for children with difficult asthma,” Owora said. “Asthma specialists can identify high-risk children earlier, start proven controller treatments sooner and surround families with a coordinated care team.”
The team plans to continue studying the effects of high-risk asthma clinics across larger and more diverse groups of children.
“We also need to study how best to build early risk alerts into everyday pediatric care, so children who are most likely to have severe asthma attacks can be referred sooner,” Owora said.
IU School of Medicine’s Samuel Strunk, Bowen Jiang, Yash Shah and Nadia Krupp are co-authors on the study.
