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Original research
Effectiveness of asthma preventer dispensing for preventing childhood asthma readmissions: a multisite cohort linkage study
  1. Katherine Ya-Hui Chen1,2,3,
  2. Nilar Aye Tun3,
  3. Renee Jones1,
  4. Shivanthan Shanthikumar4,5,
  5. John B Carlin3,6,
  6. Harriet Hiscock1,3,7
  1. 1 Health Services Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  2. 2 General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  3. 3 Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Respiratory and Sleep Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  5. 5 Respiratory Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  6. 6 Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  7. 7 Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Katherine Ya-Hui Chen, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; katherine.chen{at}mcri.edu.au

Abstract

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.

  • Paediatrics
  • 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.

https://doi.org/10.1136/archdischild-2022-324549

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    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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    Footnotes

    • 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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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