Abstract
Aim: To investigate prevalence, management and disease control in severe asthma in Sweden.
Method: Patients ≥18 years with a drug collection for obstructive pulmonary disease during 2011 – 2012 and diagnosed asthma (ICD-10 J45-J46) were identified (index). Primary care medical records were linked to national Swedish health registries. Severe asthma classified as collection of inhaled steroid >800 budesonide or equivalent + leukotriene receptor antagonist and/or long-acting beta-agonist. Poor asthma control defined as collection of ≥600 doses of short-acting beta2-agonists per year, or any exacerbation (asthma-related hospitalizations, emergency visits and/or collection of oral steroids). Data adjusted for age.
Results: Of 18724 asthma patients, severe asthma was identified in 790 patients (4.2%). Mean age 56.9 years compared to 48.8 years in the mild-moderate asthma group (p<0.001). FEV1 % pred was 67.5% vs 83.6% (p<0.001), respectively. Asthma related yearly visits were more frequent in the severe asthma group, in primary care 31% vs 21% (p <0.001); specialist care 21% vs 7% (p<0.001). Risk of acute exacerbations was higher in the severe asthma group (100 events per 100 patient years) than the mild-moderate group (34 events per 100 patient years; relative risk [95 %CI] 2.59 [2.41-2.79]; p<0.001). One-year post index, poor asthma control was observed in 53.6% of patients in the severe group vs 28.2% in the mild-moderate group (<0.001).
Conclusion: In this asthma population, a minority of the severe asthma patients had contact with specialist care and half of the patients had poor asthma control, indicating suboptimal management and substantial under treatment of severe asthma.
Study sponsor: AstraZeneca
- Copyright ©the authors 2017