Abstract
Introduction: In the worldwide context of population ageing, it is essential to better characterize asthma therapeutic management in elderly, a population with coexisting conditions.
Aim: To characterize asthma treatment level in real life and its evolution over time in old women.
Methods: The analysis was conducted in women with ever asthma included in the 20-year E3N cohort of members of MGEN, a French national health insurance, with individual and respiratory-health characteristics. The level of asthma medication was calculated each calendar year from 2004 to 2011, following the GINA 2014 classification, from the drug dispensed database. Uncontrolled asthma was assessed in 2011 by Asthma Control Test (ACT) <20.
Results: Among the 6,268 women with ever asthma, aged 62.2±6.2 yrs at inclusion, 70.5% were recorded as users of drugs for obstructive airway diseases between 2004 and 2011. Among them, the level of asthma treatment was stable at the population and individual levels during the analysis period, with in 2011: 0.2%, 5.8%, 18.0%, 10.1%, 10.5% in step 5 to 1 respectively, and 55.4% with no asthma treatment included in GINA classification. A regular increase of inhaled anticholinergic reimbursements was observed during this period (0.5% to 4.0%). Uncontrolled asthma was found in about one third of women with asthma maintenance therapy in the 12 months preceding ACT (33%, 30% and 37% for step 2, 3 and 4 respectively) and 19% among women using only reliever therapy.
Conclusions: This is one of the first studies assessing asthma therapeutic management in the elderly. A high proportion of uncontrolled asthma was observed in this population whatever asthma treatment level.
Fundings: IReSP.
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