P-33 Longitudinal trends in the profile of Prior Asthma Management in Children Hospitalized for Acute Severe Asthma in Barbados

Methods: This study uses a prospective cohort design. Study period extended from January 2024 through December 2024. The relevant data were extracted from the medical records of children aged 1 month – <16 years who were hospitalized for ASA at the QEH at their discharge. Additional Data were collected through one-to-one interview of the care giver of the child. Findings from 2024 were compared with the findings from a previous study over the period 2015 to 2019 in this very setting. '

Results: A total of 233 children were hospitalized for acute severe asthma during the year 2024, the majority (34.8%) of the children were in the age group 4 - <8 years age group, with a higher proportion of male patients (68.7%). Most (83.3%) of these children had a history of prior recurrent wheezing and 20.6% had a history of previous hospitalization for acute asthma. Among the 194 hospitalizations for acute asthma, a history of prescribed ICS was present in only 116 (59.8%) instances and only 65% of those prescribed ICS demonstrated good adherence to the ICS and 37 (19.1) did not have any follow-up for their recurrent wheezing or asthma. Only 18 (9.3%) had Personalized Asthma Action Plan. During the 2015-2019 period, of the PICU admissions, 76 (75.2%) and 47 (46.5%) had previous hospitalization and PICU admissions respectively. During this same period, among those admitted to PICU 29 (28.7%), 61 (60.4%) and 11 (10.9%) were on daily inhaled corticosteroids (ISC), were non-compliant with their ICS and were not on any ICS.

Conclusion: The results of this study confirm that a history of poor asthma management is a key determinant in the hospitalization of children for acute severe asthma. Nonadherence to asthma medications, lack of proper asthma control, and exposure to environmental triggers contribute significantly to the severity of exacerbations.