The current state of pediatric asthma in Australia, a letter to the editor 2024

Letter to the Editor, emphasising latest data/findings on childhood asthma in Australia including:
Facts:
– High prevalence (8.5% for children 0-14)
– Leading cause of burden of disease
– Hospital admissions have decreased in the last decade
– About 1 in 10 children dispensed SABA (e.g. Ventolin) through the PBS (as opposed as over the counter) have poor asthma control
– Only one in three (29%) children that have been dispensed a preventer used it regularly
– Overreliance on SABAs (reliever) and underuse of ICS are an enduring problem in childhood asthma, as these indicators have not improved in the last 5 years
– 1 in 3 hospitalised children is readmitted within 12 months for asthma (compared to 1 in 5 a decade ago) — Note: this is from a study looking at children admitted in 2017-18
– only 16.2% of children admitted to the hospital due to asthma were prescribed ICS before admission, and of those who were not on a preventer at the time of admission only 12.2% were commenced during the admission
– only 25.6% of children admitted to the hospital with asthma received asthma education and only one‐third of children had an assessment of their inhaler technique during their admission
– several studies from across Australia highlight guideline‐ discordant care across many settings (including pediatricians), which is a known risk factor for hospital readmission

Barriers:
A lack of standardized management and asthma action plans, inadequate systems to allow for timely follow‐up with GPs, inadequate asthma education for parents/carers, and lack of integrated asthma care between GPs and hospitals7 are some of the barriers to optimal asthma management in Australian children.

What is needed:
Multidimensional interventions have been shown to improve asthma control and reduce hospitalization, including asthma self‐management education, home environmental assessment regarding potential asthma triggers and supporting families to deliver asthma care at home, care coordination between primary and tertiary care, and school involvement to support the administration of asthma medications.