Abstract
Background: The International Severe Asthma Registry (ISAR) defines severe asthma as those on GINA step 5 or uncontrolled on step 4. These patients should be referred to specialist providers. But, severity may be mis-estimated in primary care and/or unrecognized (ie never referred to specialist care).
Aim: To identify potential severe asthma patients in UK primary care.
Methods: A historical cohort study was conducted using the Optimum Patient Care Research Database. Eligible patients had an active diagnosis of asthma (pre 2014), were ≥16 yrs old, and had ≥1 asthma medication within the past year. Patients were categorized according to GINA step and number exacerbations/yr. % of patients on GINA step 4 or 5 with no recorded specialist referral was also assessed.
Results: 207,695 patients were included. 2.3% of GINA step 1 patients had ≥2 exacerbations/yr, rising to 3.2%, 5.0%, 12.8%, and 40.9% of those on GINA steps 2, 3, 4 and 5, respectively (Figure). 89.8% of patients at GINA step 5 or uncontrolled on step 4 had no specialist contact recorded in their last year of available data.
Conclusion: The prevalence of severe asthma may be higher than previously estimated. Treatment resistant asthma due to other factors (e.g. adherence, technique, co-morbidities) cannot be discounted. Further analyses using detailed referral information will be undertaken and outcomes for unrecognized severe asthma patients in UK primary care compared with ISAR data.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2712.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019