Severe asthma risk persists in London children

Background: The North West London (NWL) Whole Systems Integrated Care(WSIC) dataset from primary and secondary care provides: i) up-to-date asthma clinical risk registers (dashboards);& ii) a research facility (Discover) of de-identified data for > 2.2 million patients. We aimed to describe the burden of asthma and risk of poor outcomes in Children and Young People (CYP:aged ≤18 years) in this population. Methods: Data was extracted from Discover on CYP coded with asthma diagnosis by General Practices (GPs) for 12 months from April 2018. Ethics approval by the NWL Data Research Access Group. Results: 14405/482029 (3%) CYP (40% female) in 329 GP practices were coded with asthma. Median prevalence 2.88% (Q1,3: 2.52%,3.38%); i.e. below national prevalence. An unknown number of CYP were treated without being coded with asthma. Exacerbations: i) 749 CYP had 797 hospital admissions (32 had 2-6): ii) 910 were coded by GPs with 1168 asthma attacks (170 had 2-12);iii)1485 had 2123 prescriptions for courses of oral corticosteroids(OCS) (408 had 2-12). 12332 CYP were prescribed SABAs: 43%, 11% and 1% had more than 3, 6 and 12 inhalers. 4328(30%) CYP were not prescribed inhaled corticosteroids(ICS); only 49% of authorized ICS prescriptions were requested by patient’s, 51% requested Asthma Control Test: 6% scored ≤19. 63% and 57% CYP were provided with personal asthma action plans and annual reviews respectivly. Conclusions: Over 10% of this population face potential life threatening asthma attacks. Improved utilisation of dynamic clinical risk registers could easily facilitate recognition of risk with optimisation of care for CYP with asthma. Study supported by AstraZeneca UK