Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper
Introduction Asthma is the most common chronic respiratory disease in children and adults. Asthma results in significant disease-related morbidity, healthcare costs and, in some cases, death. Despite efforts through implementation of national guidelines to improve asthma care, the UK has one of the...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-08-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/8/e058356.full |
| _version_ | 1798037546107666432 |
|---|---|
| author | Krishnarajah Nirantharakumar Nicola Adderley Richard Hotham Rasiah Thayakaran Prasad Nagakumar Shamil Haroon Adel Mansur Nikita Simms-Williams |
| author_facet | Krishnarajah Nirantharakumar Nicola Adderley Richard Hotham Rasiah Thayakaran Prasad Nagakumar Shamil Haroon Adel Mansur Nikita Simms-Williams |
| author_sort | Krishnarajah Nirantharakumar |
| collection | DOAJ |
| description | Introduction Asthma is the most common chronic respiratory disease in children and adults. Asthma results in significant disease-related morbidity, healthcare costs and, in some cases, death. Despite efforts through implementation of national guidelines to improve asthma care, the UK has one of the highest asthma-related morbidity and mortality rates in the western world. New approaches are necessary to prevent asthma attacks in children and adults. The objectives of this study are to assess the association between demographic and clinical factors and asthma-related hospital admissions in children and adults, describe the epidemiology of asthma phenotypes among hospital attenders, and externally validate existing asthma risk prediction models.Methods and analysis This is a retrospective cohort study of children and adults with asthma. Data will be extracted from the Clinical Practice Research Datalink (CPRD) Aurum database, which holds anonymised primary care data for over 13 million actively registered patients and covers approximately 19% of the UK population. The primary outcome will be asthma-related hospital admissions. The secondary outcomes will be prescriptions of short courses of oral corticosteroids (as a surrogate measure for asthma exacerbations), a composite outcome measure including hospital admissions and prescriptions of short courses of oral corticosteroids and delivery of asthma care management following hospital discharge. The primary analysis will use a Poisson regression model to assess the association between demographic and clinical risk factors and the primary and secondary outcomes. Latent class analysis will be used to identify distinct subgroups, which will further our knowledge on potential phenotypes of asthma among patients at high risk of asthma-related hospital admissions. A Concordance statistic (C-statistic) and logistic regression model will also be used to externally validate existing risk prediction models for asthma-related hospitalisations to allow for the optimal model to be identified and evaluated provide evidence for potential use of the optimal performing risk prediction model in primary care.Ethics and dissemination This study was approved by the CPRD Independent Scientific Advisory Committee (reference number: 21_000512). Findings from this study will be published in a peer-reviewed journal and disseminated at national and international conferences. |
| first_indexed | 2024-04-11T21:28:00Z |
| format | Article |
| id | doaj.art-d1661afa6d424a2bad620db9189806b9 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T21:28:00Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-d1661afa6d424a2bad620db9189806b92022-12-22T04:02:20ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2021-058356Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paperKrishnarajah Nirantharakumar0Nicola Adderley1Richard Hotham2Rasiah Thayakaran3Prasad Nagakumar4Shamil Haroon5Adel Mansur6Nikita Simms-Williams7Public Health, University of Birmingham, Birmingham, UKInstitute of Applied Health Research, University of Birmingham, Birmingham, UK1 Academic Unit of Primary Medical Care, The University of Sheffield, Sheffield, UKInstitute Of Applied Health Research, University of Birmingham, Birmingham, UKInstitute of Inflammation and Ageing, University of Birmingham, Birmingham, UKassociate clinical professor in public health9Heart of England NHS Foundation Trust, Birmingham, UKUniversity of Birmingham Institute of Applied Health Research, Birmingham, UKIntroduction Asthma is the most common chronic respiratory disease in children and adults. Asthma results in significant disease-related morbidity, healthcare costs and, in some cases, death. Despite efforts through implementation of national guidelines to improve asthma care, the UK has one of the highest asthma-related morbidity and mortality rates in the western world. New approaches are necessary to prevent asthma attacks in children and adults. The objectives of this study are to assess the association between demographic and clinical factors and asthma-related hospital admissions in children and adults, describe the epidemiology of asthma phenotypes among hospital attenders, and externally validate existing asthma risk prediction models.Methods and analysis This is a retrospective cohort study of children and adults with asthma. Data will be extracted from the Clinical Practice Research Datalink (CPRD) Aurum database, which holds anonymised primary care data for over 13 million actively registered patients and covers approximately 19% of the UK population. The primary outcome will be asthma-related hospital admissions. The secondary outcomes will be prescriptions of short courses of oral corticosteroids (as a surrogate measure for asthma exacerbations), a composite outcome measure including hospital admissions and prescriptions of short courses of oral corticosteroids and delivery of asthma care management following hospital discharge. The primary analysis will use a Poisson regression model to assess the association between demographic and clinical risk factors and the primary and secondary outcomes. Latent class analysis will be used to identify distinct subgroups, which will further our knowledge on potential phenotypes of asthma among patients at high risk of asthma-related hospital admissions. A Concordance statistic (C-statistic) and logistic regression model will also be used to externally validate existing risk prediction models for asthma-related hospitalisations to allow for the optimal model to be identified and evaluated provide evidence for potential use of the optimal performing risk prediction model in primary care.Ethics and dissemination This study was approved by the CPRD Independent Scientific Advisory Committee (reference number: 21_000512). Findings from this study will be published in a peer-reviewed journal and disseminated at national and international conferences.https://bmjopen.bmj.com/content/12/8/e058356.full |
| spellingShingle | Krishnarajah Nirantharakumar Nicola Adderley Richard Hotham Rasiah Thayakaran Prasad Nagakumar Shamil Haroon Adel Mansur Nikita Simms-Williams Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper BMJ Open |
| title | Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper |
| title_full | Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper |
| title_fullStr | Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper |
| title_full_unstemmed | Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper |
| title_short | Preventing unscheduled hospitalisations from asthma: a retrospective cohort study using routine primary and secondary care data in the UK (The PUSH-Asthma Study)—protocol paper |
| title_sort | preventing unscheduled hospitalisations from asthma a retrospective cohort study using routine primary and secondary care data in the uk the push asthma study protocol paper |
| url | https://bmjopen.bmj.com/content/12/8/e058356.full |
| work_keys_str_mv | AT krishnarajahnirantharakumar preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT nicolaadderley preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT richardhotham preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT rasiahthayakaran preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT prasadnagakumar preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT shamilharoon preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT adelmansur preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper AT nikitasimmswilliams preventingunscheduledhospitalisationsfromasthmaaretrospectivecohortstudyusingroutineprimaryandsecondarycaredataintheukthepushasthmastudyprotocolpaper |