Educational and health outcomes of children treated for asthma: Scotland-wide record linkage study of 683,716 children

Fleming, M. , Fitton, C. A., Steiner, M. F.C., McLay, J. S., Clark, D., King, A., Mackay, D. F. and Pell, J. P. (2019) Educational and health outcomes of children treated for asthma: Scotland-wide record linkage study of 683,716 children. European Respiratory Journal, 54(3), 1802309. (doi:10.1183/13993003.02309-2018) (PMID:31196949) (PMCID:PMC6727030)

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Abstract

Background: The global prevalence of childhood asthma is increasing. The condition impacts physical and psychosocial morbidity; therefore wide-ranging effects on health and education outcomes are plausible. Methods: Linkage of eight Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions and unemployment, provided data on 683 716 children attending Scottish schools between 2009 and 2013. We compared schoolchildren on medication for asthma with peers, adjusting for sociodemographic, maternity and comorbidity confounders, and explored effect modifiers and mediators. Results: The 45 900 (6.0%) children treated for asthma had an increased risk of hospitalisation, particularly within the first year of treatment (IRR 1.98, 95% CI 1.93–2.04), and increased mortality (HR 1.77, 95% CI 1.30–2.40). They were more likely to have special educational need for mental (OR 1.76, 95% CI 1.49–2.08) and physical (OR 2.76, 95% CI 2.57–2.95) health reasons, and performed worse in school exams (OR 1.11, 95% CI 1.06–1.16). Higher absenteeism (IRR 1.25, 95% CI 1.24–1.26) partially explained their poorer attainment. Conclusions: Children with treated asthma have poorer education and health outcomes than their peers. Educational interventions that mitigate the adverse effects of absenteeism should be considered.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Mackay, Professor Daniel and Fleming, Dr Michael
Authors: Fleming, M., Fitton, C. A., Steiner, M. F.C., McLay, J. S., Clark, D., King, A., Mackay, D. F., and Pell, J. P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:European Respiratory Journal
Publisher:European Respiratory Society
ISSN:0903-1936
ISSN (Online):1399-3003
Published Online:13 June 2019
Copyright Holders:Copyright © 2019 ERS
First Published:First published in Transboundary and Emerging Diseases 54(3):1802309
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
603761The Scottish eHealth Informatics Research Centre (E-HIRCs)Jill PellMedical Research Council (MRC)MR/K007017/1IHW - PUBLIC HEALTH