Asthmatic children from lower‐income families are less likely to own an individualised asthma action plan

Abstract

Aim This study aimed to explore the relationship between indicators of socio‐economic status (SES) and prescription of a paediatric individualised asthma action plan (IAAP), as well as compliance with that plan. Methods Between May and September 2017, parents/carers of children aged 2–16 years who presented with acute respiratory symptoms and a prior diagnosis of asthma to the emergency department at one regional and one metropolitan hospital in NSW, Australia, were invited to participate in a questionnaire‐based study. Results A total of 175 eligible participants were identified, of which 113 completed the questionnaire. Eighty‐seven children had been prescribed an IAAP (77%). Forty‐nine parents/carers reported non‐compliance with that plan (56.3%). Children from low‐ to middle‐income families were significantly less likely to have a plan (P = 0.001). Being an only child was associated with greater IAAP compliance (P = 0.007) and better asthma control (P = 0.035). No significant relationship between other indicators of SES and rates of plan ownership or compliance was demonstrated. Conclusion Although relatively high in our study sample, IAAP ownership rates remain well below published guidelines. Given the income‐based disparity in plan ownership, physicians must routinely prescribe plans to all asthmatics. Strategies to ensure IAAP ownership and promote their use, especially in the public health sector, would be valuable. Repeating a similar study with a larger sample size will allow more robust conclusions to be drawn regarding the impact of parental SES on compliance.

Sleepwalking towards more harm from asthma

“…14 However, children aged under 15 years still constitute the largest proportion of people presenting to emergency departments in Australia with a respiratory condition, and asthma is the leading preventable cause of these presentations. [15][16][17] Respiratory conditions generally account for the highest proportion of emergency department presentations in relation to other disease systems, and around one-third of these people are admitted to hospital. 5 These presentations and admissions for asthma comprise a large group of patients with a readily treatable disease.…”

Pediatric Asthma Action Plans: National Cross-Sectional Online Survey of Parents' Perceptions (Preprint)

“…AAP effectiveness may be influenced by income and literacy. There are several factors that may create challenges for those with lower income and asthma, including access to medical care, an urban environment, and lower literacy [14]. Lower-income families are less likely to have an AAP [14] and have an increased risk for asthma treatment failure and exacerbations [15].…”

“…There are several factors that may create challenges for those with lower income and asthma, including access to medical care, an urban environment, and lower literacy [14]. Lower-income families are less likely to have an AAP [14] and have an increased risk for asthma treatment failure and exacerbations [15]. Low literacy has been linked to misunderstandings of AAP medications and instructions [16], as well as greater asthma severity [17].…”