A review of the management of childhood asthma in Tasmania

Objective: To review the current management of childhood asthma in Tasmania and highlight evidence‐practice gaps for future interventions. Methods: A software application (MedeMine) that extracts data from the Fred Dispense pharmacy dispensing software system was modified to identify children with asthma. Participating community pharmacies ran the software application. Caregivers of identified children were mailed a survey to evaluate components of asthma management. Dispensing and survey data were analysed. Results: Twenty‐three community pharmacies were recruited. A total of 948 children were identified by the software and deemed eligible for inclusion. Surveys were received from 362 (38.2%) caregivers. In the past year, short‐acting beta‐2 agonists were used by 56.1% of the cohort, preventers by 76.5% (inhaled corticosteroids 52.3%; leukotriene receptor antagonists 31.3%; inhaled cromones 0.6%), long‐acting beta‐2 agonists (LABAs) by 25.7% and oral corticosteroids by 21.5%. Approximately half of the children using inhaled corticosteroids were concurrently using a LABA. Survey data indicated 52.7% had an Asthma Action Plan (AAP), and 49.6% used a spacer regularly. Among children with potential indicators of inadequately controlled asthma (emergency department visits, over‐use of reliever medication and oral corticosteroid use), up to 25% were not using a preventer and up to 75% of their parents reported that their asthma was adequately controlled. Conclusions: These results indicate gaps in childhood asthma management, in particular, underutilisation of preventers in high‐risk patient groups, high utilisation of LABAs, insufficient spacer and AAP usage and overestimation of asthma control. These areas could be targeted in future interventions to improve childhood asthma management.