Grant: Project Grant

Background: Asthma is one of the most common chronic diseases in childhood and is a leading cause of emergency department (ED) visits and hospitalizations. Despite improvements in available treatments, ED visit and hospitalization rates for asthma remain high. Currently, children who leave the ED following an asthma exacerbation do not always receive comprehensive asthma education or get started on asthma controller medications, even though these strategies are known to prevent repeat asthma visits. This may be due to physician discomfort in prescribing these treatments or lack of asthma educators. However, these treatments are likely only needed for children who are at high risk for repeat ED visits or asthma hospitalizations. There are currently no guidelines to direct clinicians how to practically identify these high-risk children before discharge from the ED. Aims: Derive a clinical risk score to identify children who are at high risk for repeat asthma ED visits or hospitalizations within 12 months following an initial asthma ED visit. Methods: We will analyze data that was collected as part of a previous study that included all children with an asthma exacerbation who came to the ED at one of five specialized pediatric hospitals. Information on characteristics of children who participated in this previous study will be linked with provincial health administrative data in Ontario and Quebec to provide information on health care outcomes one year after their initial ED visit, and specifically whether the children were hospitalized or had repeat ED visits for asthma. This information will be used to develop a clinical score to identify high-risk asthma patients. Expected Outcomes: This study will allow us to develop a simple method to identify children at high-risk for future asthma ED visits or hospitalizations. This method can be used in future to target treatments to high-risk patients who would benefit most.