Abstract
Background Previous studies reported a high burden of uncontrolled asthma in Europe. The relationship between treatment step, smoking status and control, however, remain underreported.
Aim To evaluate the distribution of asthma control across guideline-recommended management steps, and the association between control and smoking status of real-life patients within a primary care setting in the UK.
Methods Patient data were extracted from the Optimum Patient Care Research Database and prospectively followed for at least 1 year. Patient-reported outcomes and practice data characterised patients' control status as defined by the Global INitiative for Asthma (GINA), current treatment management step and smoking status.
Results Of 91,393 eligible patients, 28% had GINA controlled asthma, 58% partially controlled and 14% uncontrolled. Control was weakly correlated with GINA management steps (Spearman's rho=0.26), with 21%, 31%, 24%, 23% and 1.4% achieving control across steps 1 to 5, respectively. During the 1-year follow-up, 11% of patients experienced at least 1 exacerbation. This proportion of patients increased across the ascending GINA steps from 5% at step 1 to 67% at step 5 (p<0.01). Non-smokers were significantly more likely to achieve control than current or ex-smokers (p<0.001).
Conclusion The majority of patients in this real-life cohort failed to achieve GINA-defined asthma control within a UK primary care setting. GINA management step was only weakly correlated with control status, but higher step management was associated with a greater risk of exacerbations. Non-smokers were significantly more likely to achieve control than current and ex-smokers.
- Copyright ©the authors 2016