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Changes in the use of anti-asthmatic medication in an international cohort

¹ Dept of Medical Sciences, Respiratory Medicine & Allergology, Uppsala University, Uppsala, Sweden. ² University of Verona , Dept of Medicine and Public Health, Unit of Epidemiology and Statistics, Verona, ⁴ Unit of Respiratory Diseases, CPA- Asl4, Turin, ⁵ Dept of Applied Health Sciences, Faculty of Medicine, and ⁶ Division of Respiratory Diseases, IRCCS "San Matteo" Hospital, University of Pavia, Pavia, Italy. ³ Unit of Epidemiology, Public Health Dept of Castilla La Mancha, Albacete, ⁷ Institut Municipal d'Investigació Mèdica (IMIM), Universitat Pompeu Fabra (UPF), Barcelona, and ¹¹ Unit/Dept of Pneumologie, University Hospitalary Complex Albacete, Albacete, Spain. ⁸ Dept of Allergy, Respiratory Medicine and Sleep, University Hospital, Reykjavik, Iceland. ⁹ Dept of Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway. ¹⁰ Tartu University Clinics, Lung Clinic, Tartu, Estonia. ¹² Dépt de Pédiatrie, CHU de Grenoble, Grenoble, France. ¹³ University of Antwerp (Campus Drie Eiken), Antwerp, Belgium. ¹⁴ Dept of Public Health Sciences, King's College London, UK.

CORRESPONDENCE: C. Janson, Dept of Medical Sciences, Respiratory Medicine and Allergology, Akademiska sjukhuset, SE 751 85 Uppsala, Sweden. Fax: 46 186112819. E-mail: christer.janson{at}medsci.uu.se

Keywords: Asthma, epidemiology, inhaled corticosteroids, smoking, therapy

Received: March 18, 2005
Accepted July 13, 2005

The aim of this study was to describe changes in pharmacotherapy for asthma since the early 1990s in an international cohort of young and middle-aged adults.

A total of 28 centres from 14 countries participated in a longitudinal study. The study included 8,829 subjects with a mean follow-up time of 8.7 yrs. Change in the prevalence of use for medication was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period.

The use of anti-asthmatics was found to have increased by 3.1% (2.4–3.7%) and the prevalence of symptomatic asthma by 4.0% (3.5–4.5%). In the sample with asthma in both surveys (n = 423), the use of inhaled corticosteroids increased by 12.2% (6.6–17.8%). Despite this, only 17.2% were using inhaled corticosteroids on a daily basis at follow-up. Females with continuous asthma were more likely, compared with males, and smokers with asthma, to have started using inhaled corticosteroids since the first survey.

The use of anti-asthmatics has increased in a pattern consistent with current consensus on treatment. However, despite increased use of inhaled corticosteroids, a large majority of subjects with symptomatic asthma do not use this treatment on a daily basis, particularly males and smokers with asthma.