Aims One of the most common triggers of asthma exacerbations are respiratory tract infections such as influenza.1 Furthermore, the National Review of Asthma Deaths (NRAD) in 2014 linked inappropriate prescribing in primary care to patient deaths.1 The primary aim of this study was to assess the uptake of the influenza vaccine in asthmatic children in Liverpool during the 2016–2017 flu season. The secondary aim of this audit was to assess if children are being prescribed asthma medication in accordance with BTS guidelines.2
Method The inclusion criteria for this retrospective study included children aged 16 and under, diagnosed with asthma and registered at a GP surgery within the Liverpool Care Commissioning Group (CCG). The practice managers at all 95 surgeries were invited to participate in this study via email. Participation included conducting a search using EMIS (Egton Medical Information Systems) to produce a paediatric asthma list that included the child’s age, gender, their current regular asthma medication, if and when the child had received the flu vaccination. Depending on their preference, the surgeries either completed an audit form or generated an anonymous EMIS search report. These documents were collected from the surgery by the researcher or returned via email. The data was analysed in SPSS using the chi-square test to determine if there were any significant associations between demographics, flu vaccination status and compliance to guidelines.
Results Information regarding flu vaccination was collected for 475 patients from seven surgeries. In total 148 (31.2%) children had received the flu vaccination during the 2016–2017 influenza season. Being registered at a GP surgery in an area of low deprivation and being aged 5 and under was associated with higher vaccination rates (p<0.05).
Data containing current asthma treatment was obtained for 297 patients. In total 194 of those (65.3%) prescriptions followed current BTS guidelines. The most common reasons for not following BTS guidelines were patients being prescribed salbutamol monotherapy or no asthma medication at all. Being male and registered at a GP surgery in an area of low deprivation was associated with being prescribed asthma medication in accordance to guidelines (p<0.05).
Conclusion The uptake of the influenza vaccine in asthmatic children in Liverpool during the 2016–2017 flu season was very low (31.2%). The majority of children were prescribed regular asthma medications in line with BTS guidelines, although there are still multiple instances of poor prescribing practice. The results suggest that age, gender and deprivation level according to postcode affect whether a child’s medication will follow BTS guidelines or whether the child will be vaccinated. More research is required to fully establish these links.
Royal College of Physicians. National Review of Asthma Deaths 2014. Available at https://www.rcplondon.ac.uk/projects/national-review-asthma-deaths (Accessed 12.12.17).
British Thoracic Society, Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma 2016. Available at https://www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2016/ (Accessed 12.12.17).
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