Grant: Partnerships for Health System Improvement (PHSI)

In Canada, asthma affects more than 12% of children. Many experience 'attacks' which are acute periods of worsening asthma symptoms linked to a variety of triggers. Over 80% of asthma attacks are triggered by upper respiratory tract virus infections or 'colds'. Currently, asthma attacks due to such infections are a major cause of Emergency Department visits, missed school days, sleep disruption and restricted physical activity in children. This project addresses two problems: a lack of precise information about the impact of severe asthma attacks in children on the health care system (information that can be used to target improvements in asthma care) and a lack of widespread use of a recommended strategy for preventing many such attacks. This strategy involves taking oral steroids for several days at the first sign of a cold or flu. The project will begin with a detailed analysis of provincial health data concerning use of hospital and physician services and medications by children who experience asthma attacks and will provide regional Health Authority planners with information they can use in identifying areas for service improvement. The second stage of the project is an evaluation of the effects of using the preventive oral steroid strategy with Emergency Department asthma patients at BC Children's Hospital. This evaluation will study changes in quality of life in children who use the strategy compared with those who do not as well as changes in future use of the Emergency Department for asthma attacks. The project team will include health care decision makers as well as clinicians and researchers to ensure that the results are widely communicated to health care providers who are in a position to make improvements in care.