Reducing recurrent preschool wheeze and asthma in children and young people in England

Aim

To compare modifiable factors to reduce the number of children and young people with recurrent preschool wheeze and asthma.

Background

Around a third of children under the age of 5 years experience wheeze. Recurrent wheeze is potentially preventable through effective primary care following an initial wheeze attack and limiting environmental risk factors such as passive smoke exposure. Few studies have examined the risk factors for re-admission or future attacks in the preschool population.

One in three children with preschool wheeze progress to an asthma diagnosis by their 6th birthday. Asthma disproportionately affects disadvantaged groups with steep social gradients in admissions. The extent to which environmental exposures in early life contribute to recurrent preschool wheeze and persistent asthma in children and young people is unknown.

Methods

We will use longitudinal data sources from the NHS to investigate the timing, and rate of, re-attendance and re-admissions for preschool wheeze. We will examine the impact of preventive care and environmental characteristics on rates of recurrent wheeze. Using a national birth cohort study, the Millennium Cohort Study, we will compare the relative impacts of modifiable early life environmental exposures on risk of recurrent wheeze and the development of asthma in mid to late childhood and adolescence.

Public involvement

We are in discussion with the NIHR Northwest London Applied Research Collaboration to facilitate local patient and public involvement. We will have a lay representative on the steering group for input and advice for the duration of the study.

Dissemination

The study findings will be presented at local national and international conferences and submitted for publication in open access peer-reviewed scientific journals. We will disseminate our findings to the public through research networks, social, print and media broadcasts and community engagement opportunities. To ensure impact of our findings we will work with policy makers for direct application.