Lucy Bindon, 5th year Medical Student, Wagga Wagga Rural School of Medicine, University of New South Wales
Introduction
Prescription rates of Individualised Asthma Action Plans (IAAP) for children are high however compliance with treatment remains sub-optimal. Poor compliance results in avoidable readmission to hospital for paediatric patients in our regions. We investigated two possible reasons why families may be non-compliant, potentially leading to hospital readmission. 1) Do parents/carers understand their child’s IAAP and 2) Are all carers being educated on how to utilise the IAAP.
Method/Description
Between May and November 2021, parents/carers of children aged 2-16 years admitted to WWBH Paediatric ward with acute wheezing were asked to complete a Questionnaire within 5 days following discharge. The questionnaire addressed whether parents understood the medications prescribed and how to deliver them. We also asked whether subjects felt the plan was easy to use and whether it had been adequately explained to them before discharge. The questionnaire further addressed the care arrangements for the child and whether all carers had access to the IAAP and had received education on how to follow the plan. The questionnaire also asked a standardised socio-economic status screen and explored ethnic minority status to evaluate any correlation with IAAP understanding compared with non-disadvantaged counterparts.
Results
Preliminary results have been collated (August 2021). A total of 24 eligible subjects were identified and consented to the study, 17 subjects completing the questionnaire. 16 mothers and 1 father completed the questionnaire). 89.4% of children were cared for by two parents living in the same household. 37.5% reported that the child was regularly cared for in another household (commonly a grandparent). Only 17.6% (3/17) subjects reported that education regarding their child’s IAAP was offered to or delivered to additional primary carers. No subjects were given an electronic copy of their child’s discharge treatment plan. 7/17 subjects reported their plan did not contain instructions on how to treat their child when a symptomatic versus when they are symptomatic and 4/17 reported their plan didn’t include instructions on when to represent to hospital. 4 subjects identified as speaking a language other than English at home however none were offered translator support.
Consclusions
Mothers take on the primary role in asthma management for regional children. Educating fathers and all other carers could be valuable in reducing morbidity and re-hospitalisation rates. Plans should contain clear instructions on when to re-present to hospital and clarity regarding treatment when well and when symptomatic. Translators should be routinely used when educating and counselling families who are culturally and linguistically diverse.