A simple letter reminder can help reduce unscheduled hospital and GP visits after the return to school in children with asthma.
AUKCAR researchers in Sheffield have conducted a study to see if a GP reminder letter sent during the summer holidays, to parents or carers of children with asthma, can reduce the number of unscheduled hospital and GP visits after the start of the new school term in September.
What is the issue?
Asthma is known to be seasonal. A number of reports have shown an increase in unscheduled medical contacts in school-aged children with asthma after the return to school after the summer break. At this time, children are exposed to new viruses and allergens which can increase the risk unscheduled hospital and GP visits.
Before the return to school in August (in England and Wales), the number of GP visits is less than other months. Also, in the same month the number of asthma prescriptions collected also falls. This reduction in prescriptions has been shown to be associated with increased hospital and GP visits in September for children with asthma.
What did the researchers do?
The study was carried out in England and Wales. General practices were randomly assigned either to sending out the letter (70 practices) or to continue with care as usual (no letter, 72 practices) to see if the letter had any effect.
The letter from the GP reminded the parent or carer to make sure the medications of their children were up-to-date, to collect new prescriptions if needed and to make sure that their children take their medication for at least 2 weeks, prior to the start of term.
What did the researchers find?
As a result of the letter being sent, they found there was an increase in the number of prescriptions collected in August and the number of asthma reviews at general practices in the same month. The number of children with asthma that have unscheduled hospital or GP visits did not fall immediately in September, but numbers did reduce in October to December.
In addition, although there is a small cost to sending out the letter, the subsequent reduction in medical visits meant the reminder letter saved the NHS money.
How to cite
Julious SA, Horspool MJ, Davis S, Bradburn M, Norman P, Shephard N, et al. PLEASANT: Preventing and Lessening Exacerbations of Asthma in School-age children Associated with a New Term a cluster randomised controlled trial and economic evaluation. Health Technol Assess 2016;20(93)