One in 10 school-aged Australian kids have asthma. Every year, more than 20,000 kids end up in hospital because of their asthma, leading to time off school and costing the health system approximately $200 million annually. The good news is that many of these childhood asthma hospitalisations can be prevented through improved care and self-management.
That’s why we are funding the Community Based Care-Coordination Study. This study will focus on giving kids with asthma a holistic healthcare experience, connecting all the important people around them (including parents/carers and their healthcare team).
About the research
The University of New South Wales will implement and evaluate the effectiveness of a comprehensive model of care. The model of care will connect all the key stakeholders involved in a child’s asthma management- including parents/carers, primary and acute care services, asthma nurses and schools/childcare services. In this way, the study will aim to provide a personalised approach to asthma care.
The study involves children aged 5-16 years old who present to the emergency department (ED) for asthma and have been to ED at least twice or have been hospitalised at least once in the last 12 months.
Kids involved in the study receive an individualised standardised Asthma Action Plan, written instructions for leaving hospital, automated text messages, linkages to relevant community services and a virtual home visit within 3 months of leaving hospital.
The study will measure hospital presentations, general practitioner attendances, missed days from school and asthma specific quality of life to evaluate the effectiveness of the model of care.
“The generous funding from Asthma Australia will enable us to implement and evaluate a comprehensive model of care aimed to reduce hospital presentations for paediatric asthma. If our model proves to be effective, we plan to implement larger trial in partnership with Asthma Australia and other relevant stakeholders, across the state to integrate comprehensive care coordination for paediatric asthma as standard of care.”
Why was funding this research important?
There are more than 20,000 childhood asthma hospitalisations each year, and many of these are preventable through best practice care and self-management. The reasons for poor asthma outcomes in children are multifaceted and include a lack of asthma education, environmental triggers, lack of coordination between healthcare services and sub-optimal support in the community. A comprehensive model of care, which enhances linkages with different stakeholders involved in the management of a child’s asthma, could be part of the solution.
About the lead researcher
Dr Nusrat Homaira MBBS, MPH, PhD (Child health)
Senior lecturer, Discipline of Paediatrics and Child Health, UNSW; Respiratory Epidemiologist, Sydney Children’s Hospital, Randwick.
CI Homaira is a medically trained paediatric respiratory epidemiologist She has extensive expertise in wide range of research methodologies from designing and establishing surveillance, application and analysis of record-linked administrative health data (“big data”); to the design and conduct of randomised controlled trials, clinical surveys, diagnostic studies and longitudinal studies, systematic reviews and meta-analyses. She leads the ImpACT Childhood asthma program within the discipline and her program of research has identified significant variations in existing paediatric asthma care in Australia:
i). Children with asthma receive guideline-adherent care on <60% of occasions of care,
ii). 3,500 Australian children aged <5 years are inappropriately dispensed fixed dose combination inhalers for asthma management annually, which is not adherent to guidelines
iii). Children hospitalised frequently with asthma have 33-51% higher risk of not completing year 12 of high school compared to peers
iv). Children hospitalised with asthma ≥4 times in 12 months have a 16 times higher risk of being hospitalised with life-threatening asthma, and;
v). Post hospital discharge asthma management pathways vary between different LHDs highlighting the need for standardisation of care. Evidence from CI Homaira’s research suggests that multicomponent community-based asthma management programs can reduce asthma morbidity in children by 80%. In collaboration with Sydney Children’s Hospital (SCH) Homaira co-developed and evaluated an integrated model of paediatric asthma care into routine clinical care at SCH. Homaira is currently the CIA on multiple high-level interventional studies evaluating model of care to improve asthma health outcomes in vulnerable children. She has published >80 peer reviewed papers including in The Lancet, Lancet Global Health, Thorax, JID, CID and PloS Medicine and presented at >30 international and national conferences. Since 2016 her research has attracted 4.5 million AUD in research funding.