You are here

Article Text

Article menu
Download PDFPDF
Short report
COVID-19 and delivery of difficult asthma services
  1. Anna-Louise Nichols1,
  2. Mayank Sonnappa-Naik1,2,
  3. Laura Gardner1,3,
  4. Charlotte Richardson1,
  5. Natalie Orr1,
  6. Angela Jamalzadeh1,
  7. Rachel Moore-Crouch1,
  8. Sukeshi Makhecha1,
  9. Charlotte Wells1,
  10. Pippa Hall1,
  11. Andrew Bush1,3,
  12. Louise Fleming1,3,
  13. Sejal Saglani1,3,
  14. Samatha Sonnappa1,3
  1. 1 Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
  2. 2 School of Medicine, Anglia Ruskin University, Chelmsford, UK
  3. 3 National Heart and Lung Institute, Imperial College London, London, UK
  1. Correspondence to Dr Samatha Sonnappa, Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London SW3 6NP, UK; s.sonnappa{at}rbht.nhs.uk

Abstract

The COVID-19 pandemic necessitated an urgent reconfiguration of our difficult asthma (DA) service. We rapidly switched to virtual clinics and rolled out home spirometry based on clinical need. From March to August 2020, 110 patients with DA (68% virtually) were seen in clinic, compared with March–August 2019 when 88 patients were seen face-to-face. There was DA clinic cancellation/non-attendance (16% vs 43%; p<0.0003). In patients with home spirometers, acute hospital admissions (6 vs 26; p<0.01) from March to August 2020 were significantly lower compared with the same period in 2019. There was no difference in the number of courses of oral corticosteroids or antibiotics prescribed (47 vs 53; p=0.81). From April to August 2020, 50 patients with DA performed 253 home spirometry measurements, of which 39 demonstrated >20% decrease in forced expiratory volume in 1 s, resulting in new action plans in 87% of these episodes. In our DA cohort, we demonstrate better attendance rates at virtual multidisciplinary team consultations and reduced hospital admission rates when augmented with home spirometry monitoring.

  • COVID-19
  • paediatrics
  • respiratory medicine
  • technology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. De-identified participant data stored at Royal Brompton Hospital.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/archdischild-2021-322335

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. De-identified participant data stored at Royal Brompton Hospital.

    View Full Text

    Footnotes

    • A-LN and MS-N are joint first authors.

    • Twitter @SukeshiMakhecha, @Sam_Sonnappa

    • Contributors A-LN and MS-N are joint first authors. A-LN and SSo designed the study. A-LN and MS-N collected and analysed data. LG assisted with statistical analysis. A-LN drafted the article. A-LN, MS-N, CR, NO, AJ, RM-C, SM, CW, PH, AB, LF, SSa and SSo revised the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.