AB012. Current burden of uncontrolled asthma in the general population: the OPCRD asthma state of the Union study
Session 1.1: Safety and Risk

AB012. Current burden of uncontrolled asthma in the general population: the OPCRD asthma state of the Union study

Anjan Nibber1, Mike Thomas2, Vicky Thomas1, Wim van Aalderen3, Eugene Bleecker4, Jonathan Campbell5, Nicolas Roche6, John Haughney7, Eric Van Ganse8, Hye-Yun Park9, Chin Kook Rhee10, Derek Skinner11, Alison Chisholm12, Job FM van Boven1, Joan B. Soriano1,13, David Price1,14

1Research in Real Ltd, Cambridge, UK; 2Department of Primary Care Research, University of Southampton, UK; 3Department of Paediatrics, Academic Medical Center, Amsterdam, Netherlands; 4Wake Forest School of Medicine, North Carolina, USA; 5Department of Clinical Pharmacy, University of Colorado, USA; 6Respiratory and Intensive Care Medicine, Cohin Hospital Group, Paris-Descartes University, France; 7Glasgow Clinical Research Facility, UK; 8Pharmacoepidemiologie, CHU-Lyon, Faculte d’Odontologie Universite Lyon 1, France; 9Division of Pulmonary and Critical Care Medicine Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 10Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; 11Optimum Patient Care Ltd, Cambridge, UK; 12Respiratory Effectiveness Group, Cambridge, UK; 13Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Cátedra UAM-Linde, Spain; 14Centre of Academic Primary Care, University of Aberdeen, UK

Background: Questionnaire-based surveys report that uncontrolled asthma is common in Europe, and associated with high healthcare costs. The relationship between treatment step control are less well described. To quantify the asthma burden within routine primary care in the UK, specifically the distribution of asthma control across guideline-recommended management steps and the association between patients’ control and smoking status.

Methods: Patients were retrospectively identified using the Optimum Patient Care Research Database and prospectively followed-up for at least 1-year. Patients’ routine clinical data and self reports were used to assess GINA control status; clinical records were used to categorise current treatment by GINA management steps and patients’ smoking status.

Results: A total of 105,018 eligible asthma patients were identified, mean (SD) age 45 (23) years; 55% female; 15% current and 24% ex-smokers. Only 20% of patients were controlled, 59% were partially controlled and 21% were uncontrolled. Control was only weakly correlated to GINA management steps (Spearman’s rho=0.15, P<0.001), 27.5%, 21.5%, 20.3%, 15.1% and 12.1% achieving control across Step 1 to 5, respectively. Similarly, the proportion with uncontrolled asthma rose across higher GINA steps (12.6%, 18.2%, 19.6%, 29.2% and 36.6%). About 13% of patients experienced at least one exacerbation in the 1-year follow-up period. Frequent exacerbations (2 or more per year) were very uncommon at lower treatment steps (step 1 11.6%, step 2 12.8%) but were significantly more common at steps 3 and 4 at 18.8% and 28.2% respectively (P<0.001 for trend with ascending treatment step).

Conclusions: In this cohort of UK primary care asthma patients, the majority failed to achieve GINA defined control. GINA management step was only weakly correlated with control status, but higher step management was associated with a greater risk of exacerbation.

Keywords: Asthma; burden; healthcare; GINA management

doi: 10.21037/jtd.2016.s012

Cite this abstract as: Nibber A, Thomas M, Thomas V, van Aalderen W, Bleecker E, Campbell J, Roche N, Haughney J, Van Ganse E, Park HY, Rhee CK, Skinner D, Chisholm A, van Boven JF, Soriano JB, Price D. Current burden of uncontrolled asthma in the general population: the OPCRD asthma state of the Union study. J Thorac Dis 2016;8(Suppl 5):AB012. doi: 10.21037/jtd.2016.s012

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