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21-02-2019 | Respiratory | News | Article

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Asthma remains a ‘significant healthcare burden’

medwireNews: An analysis of electronic primary care records indicates that the prevalence of asthma continues to be high in the UK, with an increasing proportion of patients treated with inhaled corticosteroids (ICS).

As reported in the European Respiratory Journal, Chloe Bloom (Imperial College London, UK) and fellow researchers used the UK’s Clinical Practice Research Datalink, which they say is “one of the world’s largest databases of longitudinal healthcare records,” to analyse asthma prevalence rates over a 10-year period.

They found that prevalence gradually decreased from 7.2% in 2006 to 6.5% in 2016, with overall rates lower in males than females, at 6.6% versus 7.9% in 2006 and 5.8% versus 7.2% in 2016.

The study authors note that the greatest decline in asthma prevalence occurred among infants and children aged less than 5 years, with this age group having the lowest prevalence (1.6%) in 2016. Adolescents aged 12–17 years had the highest asthma prevalence (8.0%) in 2016, while rates in the other age categories (5–11 years, 18–24 years, 25–54 years and ≥55 years) ranged from 6.6 to 7.1%.

Therefore, “[a]sthma remains highly prevalent and a significant healthcare burden”, write the investigators.

Bloom and colleagues demonstrated that the proportion of asthma patients treated with ICS rose from 65% in 2006 to 80% in 2016, with patients aged younger than 5 years and those aged 55 years and older having the highest rates of ICS use. The greatest relative increase in ICS prescriptions over the study period was seen in those aged less than 5 years, at 47.5%, while the smallest relative increase occurred in the oldest age group, at 20.7%.

The percentage of patients given add-on therapy for asthma also increased across all age groups between 2006 and 2016, as did the proportion attending an annual asthma review (38.6% in 2006 and 43.7% in 2016) and having an asthma management plan (6.2% and 19.7%, respectively).

In line with this rise in the likelihood of patients receiving ICS and add-on therapies, the number of exacerbations treated in primary care has increased across all age categories, say the researchers, with 7.8–19.8% of exacerbations managed in primary care practices in 2006, rising to 12.3–29.5% in 2016.

“These findings suggest a trend towards more aggressive asthma management, and may indicate a reticence to give a formal asthma diagnosis until a certain level of disease severity”, conclude Bloom and team.

By Claire Barnard

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

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