Half of the children who died from an asthma attack in the last 10 years in NSW had not been seen by specialist for their asthma, a review finds.

Furthermore, the review of  20 deaths from asthma in the last 10 years in NSW showed that the overwhelming majority (17/19) of children only appeared to see a general practitioner at times of crisis, rather than for a planned review.

While over half of the children had been hospitalised for asthma in the year before their death, most did not have any clinical review arranged after discharge, the review by researchers from the Children’s Hospital at Westmead in Sydney showed.

More than half of the children had families with psychosocial issues such as family breakdown or domestic violence, and 40 percent had a child protection history.

In most cases the child’s school was aware that the child had asthma, reported the authors led by Professor Dominic Fitzgerald, a paediatric respiratory specialist at the hospital.

The review showed there were clear deficiencies in communication about asthma treatment and review between the hospital system, GPs, schools and social services, Professor Fitzgerald and colleagues said.

There were three potential areas of improvement in the co-ordination of asthma care for vulnerable children that emerge from this review, they said.

“They relate to medical oversight of children with persistent asthma in the hospital and community setting, consistent approaches in schools for children identified as having asthma and better diligence in addressing asthma as a significant health problem in children notified to child protection agencies,” they concluded.