Although asthma is one of the most common respiratory conditions for children, kids don’t always carry their inhalers, or may not even know they have asthma. State legislatures have implemented stock inhaler programs to ensure that schools have an asthma reliever, such as albuterol, which can be used by any child experiencing respiratory distress in the school setting.

But even in states with strong stock inhaler/albuterol laws, school administrators and prescribing clinicians fear liability in prescribing and administering the stock inhalers, according to research presented at ACAAI 2022.

“Having an asthma reliever inhaler, such as albuterol, available to any child who might be experiencing respiratory distress is vital to addressing asthma symptoms and/or emergencies that may happen during the school day,” says allergist Andrea A. Pappalardo, MD, ACAAI member and lead author of the study. “We wanted to examine the barriers and facilitators to stock inhaler programs in schools in Illinois and throughout states with similar legislation to better understand how we can improve medication access throughout our state, and nationwide.”

The researchers conducted 20 key stakeholder interviews with nurses, clinicians and school administrators in Illinois and found that 35% of those interviewed cited difficulty obtaining prescriptions for stock inhalers as a barrier to implementation. Liability concerns were one reason for the inability to secure prescriptions.

“Even though Illinois has strong wording to protect prescribers of stock inhalers and those who administer stock inhalers, prescribers are still cautious of providing a prescription for stock inhalers and related supplies to school districts. Without a prescription, stock inhalers cannot be implemented in schools. Enhanced education and the verbiage related to liability will alleviate these concerns and improve uptake of stock inhalers in Illinois, and other states” says Dr. Pappalardo.

“Stock inhaler programs provide critical reliever inhaler access in schools where children spend most of their day. Children and staff can benefit from having a stock inhaler available when an inhaler is not present at the school for that individual due to lack of diagnosis, forgetting it at home, or inability to obtain an inhaler for a multitude of access-related issues. Having potentially life-saving medications for asthma emergencies and daily symptoms alike is critical to keeping our children in class where they belong.”