Objectives To (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.
Design Multisite cohort study with linked administrative data.
Participants Children aged 3–18 years admitted with asthma to a tertiary paediatric, mixed paediatric and adult, or regional hospital between 2017 and 2018.
Main outcome measure Hospital readmission for asthma within 12 months.
Results Of 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.
Conclusions There 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.
- Respiratory Medicine
- Health services research
Data availability statement
Data are available upon reasonable request. The corresponding author, KY-HC, has access to the complete study data which can be shared on request.
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Contributors KY-HC and HH contributed to the design, funding, running of the study, analysis, write-up and revisions of the paper. NAT, RJ, SS and JBC contributed to the recruitment, data collection, data analysis and revision of drafts. KC acts as the guarantor for the overall content.
Funding This work was funded by the Melbourne Academic Centre for Health, Rapid Applied Research Translation 2.1 Grant.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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