Nusrat Homaira

University of New South Wales

Nusrat is an Early Career Fellow of National Health and Medical Research Council of Australia and a Senior Lecturer with the Discipline of Paediatrics, School of Women’s and Children’s Health at UNSW Australia. She also holds an honorary Research Scientist position within the respiratory department of Sydney Children’s Hospital, Randwick. Nusrat is a medically trained respiratory epidemiologist with more than 12 years working experience in the field of epidemiological and population health research in both low- and high-income countries.

Prior to coming to UNSW Nusrat worked as an Assistant Scientist, Centers for Communicable Diseases at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). She has expertise in wide range of research methodologies from outbreak investigation, 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.

Nusrat’s current work centres around understanding and modifying the intersection between early childhood respiratory infections and chronic respiratory conditions in high-risk populations through epidemiological and health system research. She is also keenly interested in research that influence health services to better address social inequalities and inadequate access to care.
Project Status: In progress, beginning 2021

Why was funding this research important?
Chronic medical conditions account for the major burden on the Australian healthcare system. One in 10 school-aged Australian children have current diagnosis of asthma, resulting in more than 20,000 hospitalisations and costing the health system approximately $200 million annually. In NSW alone there are more than 10,000 children presenting to emergency departments with acute asthma flare-ups every year. Most of the paediatric asthma hospital presentations can be prevented through better clinical care and patient system and self- management .

The reasons for poor progress in pediatric asthma control are multifaceted, including inadequate asthma education, failure to mitigate environmental triggers, lack of coordination within and between healthcare services and sub-optimal support in the community.

As the roots of these problems often lie outside the acute care system, there is growing interest in implementing effective comprehensive model of care that aims to enhance linkages with different stakeholders involved in management of a child’s asthma. Over the years, numerous asthma management programs have been developed in Australia in different care settings. However, these programs have not effectively integrated different levels of care to provide a comprehensive model of care.

“We will implement and test a model of care that is flexible and adopts digital innovations when necessary so that care for asthma can be provided ‘from home’ thereby reducing the burden of potentially preventable hospital presentations and avoiding any disruption to services during health crisis.”
Nusrat Homaira

What are the researchers doing?
The researchers will implement and evaluate the effectiveness of a comprehensive model of care that 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 to provide personalised approach to asthma care and lead 80% reduction in peadiatric asthma hospital presentations.
Children aged 5-16 years old, who present to emergency department for asthma and have had two or more ED visits, or 1 or more hospitalisaiton in the previous 12 months, will be assigned by a care coordinator to the study. The intervention will include; individualised Asthma Action Plan, written discharge instructions, emailed post discharge instructions and automated text messages to further support. Participants will also be linked with relevant community services, including a virtual home visit every 3 months.

Outcomes including the rate of hospital presentation and GP attendances, missed days from school and asthma specific quality of life will be compared before and after the intervention, and to a comparison group.

“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.”
Nusrat Homaira