Abstract
Asthma is one of the most common chronic diseases in children globally. Previous studies have shown that not attending asthma primary care consultations is associated with poorer treatment adherence and increased risk of loss of asthma control on a short-term basis. Here, we investigated long-term patterns and predictors of not attending scheduled asthma outpatient visits during 5-years of follow-up in 146 children with asthma. Of the 146 children, 67 (46%) did not attend at least one scheduled appointment, amounting to a total of 122 (10.8%) missed of 1133 scheduled appointments. In a multivariate analysis adjusting for total scheduled visits in the 5-year period any allergic sensitization was a significant risk factor for not attending ≥1 scheduled appointment (aOR = 6.6 (95% CI, 1.3–39.7), p = 0.03), which was not the case for asthma treatment step or lung function. Furthermore, atopic predisposition decreased the risk of non-attendance (aOR = 0.36 (0.13–0.92), p = 0.04). We found no association between non-attendance, treatment adherence or loss of asthma control. This study highlights that allergic comorbidity, but not degree of asthma severity, identifies a group of children with asthma who are prone to not attend scheduled outpatient appointments.
Highlights
Asthma is a very common childhood disease and a rising incidence has been observed worldwide [1]
Were more likely to attend their outpatient visits during a 12-month follow-up period [3]. Another large retrospective study of 1427 children 2–17 years of age showed that children attending primary care consultations with asthma within the past year were less likely to visit the emergency department (ED) with exacerbations [6]. Both these previous studies only had a follow-up period of one year, which is a short timeframe, for children having mild-moderate disease burden, who are typically scheduled for 1–2 annual asthma consultations
We investigated long-term patterns and predictors of not attending scheduled asthma outpatient visits among 146 children and adolescents with mild to moderate asthma, who were followed during a 5-year period with the aim to identify risk factors of non-attendance
Summary
Asthma is a very common childhood disease and a rising incidence has been observed worldwide [1]. In a US cohort study of 5656 children with asthma, age 5–17 years, it was observed that patients who were younger, had higher use of asthma medication and lower BMI were more likely to attend their outpatient visits during a 12-month follow-up period [3] Another large retrospective study of 1427 children 2–17 years of age showed that children attending primary care consultations with asthma within the past year were less likely to visit the emergency department (ED) with exacerbations [6]. Both these previous studies only had a follow-up period of one year, which is a short timeframe, for children having mild-moderate disease burden, who are typically scheduled for 1–2 annual asthma consultations
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