Abstract
ObjectivesTo (1) describe the dispensing of asthma preventers at hospital discharge and estimate its effect on hospital readmissions, and (2) estimate the effect of community asthma preventer dispensing on readmissions for the subgroup of children who were not prescribed an asthma preventer at discharge.DesignMultisite cohort study with linked administrative data.ParticipantsChildren aged 3–18 years admitted with asthma to a tertiary paediatric, mixed paediatric and adult, or regional hospital between 2017 and 2018.Main outcome measureHospital readmission for asthma within 12 months.ResultsOf the 767 participants, 201 (26.2%) were newly prescribed or requested to continue with asthma preventers. Of these, only 91 (45.3%) dispensed their discharge prescription within 3 days or had an active prescription. There was no evidence for a protective effect of discharge asthma preventer dispensing on asthma hospital readmissions within 12 months (OR 1.17, 95% CI 0.69 to 1.97, p=0.57). Of the 566 children who were not prescribed asthma preventers at discharge, 269 (47.5%) had one or more prescriptions dispensed in the community within 12 months. Participants who were in the protected period (asthma preventer dispensed) had reduced risk of an asthma hospital readmission (HR 0.61, 95% CI 0.36 to 1.02, p=0.06), including preschool children (HR 0.48, 95% CI 0.25, 0.93, p=0.03) on subgroup analysis.ConclusionsThere was a low rate for prescribing and dispensing of hospital discharge asthma preventers and no protective effect was found for its impact on readmissions. A protective effect on readmissions was found for community asthma preventer dispensing.
Funder
Melbourne Academic Centre for Health, Rapid Applied Research Translation
Subject
Pediatrics, Perinatology and Child Health
Reference21 articles.
1. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the global burden of disease study 2015;Hay;Lancet Respir Med,2017
2. AIHW National Hospital Morbidity Database . Chronic respiratory conditions. 2018. Available: https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-respiratory-conditions/overview
3. Chen K , Hiscock H . Asthma and staying out of hospital. Pursuit: The University of Melbourne, 2020.
4. After asthma: redefining airways diseases
5. At-risk children with asthma (ARC): a systematic review