학술논문
Characterisation of the Australian Adult Population Living with Asthma: Severe--Exacerbation Frequency, Long-Term OCS Use and Adverse Effects
ORIGINAL RESEARCH
ORIGINAL RESEARCH
Document Type
Academic Journal
Author
Hancock, Kerry L.; Bosnic-Anticevich, Sinthia; Blakey, John D.; Hew, Mark; Chung, Li Ping; Cvetkovski, Biljana; Claxton, Scott; Fante, Peter Del; Denton, Eve; Doan, Joe; Ranasinghe, Kanchanamala; Morgan, Lucy; Sharma, Anita; Smith, Peter K.; Stewart, Deb; Thompson, Philip J.; Wiseman, Russell; Upham, John W.; Yan, Kwok Y.; Carter, Victoria; Dhillon, Kiranjeet; Heraud, Florian; Le, Thao; Vella, Rebecca; Price, David
Source
Pragmatic and Observational Research. July 31, 2022, Vol. 13, p43, 16 p.
Subject
Language
English
ISSN
1179-7266
Abstract
Introduction Asthma is a chronic respiratory condition characterised by underlying airway inflammation and bronchoconstriction, which can fluctuate in severity and frequency over time. (1) The prevalence of asthma in the [...]
Introduction: Asthma poses a significant burden for the Australian population. Understanding severe exacerbation rates, and steroid-related burden for adults diagnosed with asthma stands to offer insights into how this could be reduced. Methods: Electronic medical records (EMR) and questionnaires from the Optimum Patient Care Research Database Australia (OPCRDA) were utilised retrospectively. OPCRDA is a real-world database with >800,000 medical records from Australian primary care practices. Outcomes were severe asthma exacerbations in Australian adults, over a 12-month period, stratified by Global Initiative for Asthma (GINA) treatment intensity steps, and steroid associated comorbidities. Results: Of the 7868 adults treated for asthma, 19% experienced at least one severe exacerbation in the last 12-months. Severe exacerbation frequency increased with treatment intensity ([greater than or equal to]1 severe exacerbation GINA 1 13%; GINA 4 23%; GINA 5a 33% and GINA 5b 28%). Questionnaire participants reported higher rates of severe exacerbations than suggested from their EMR (32% vs 23%) especially in steps 1, 4 and 5. Patients repeatedly exposed to steroids had an increased risk of osteoporosis (OR 1.95, 95% CI 1.43-2.66) and sleep apnoea (OR 1.78, 95% CI 1.30-2.46). Conclusion: The Australian population living with GINA 1,4, 5a and 5b asthma have high severe exacerbation rates and steroid-related burden, especially when compared to other first world countries, with these patients needing alternative strategies or possibly specialist assessment to better manage their condition. Keywords: asthma, exacerbations, oral corticosteroids, adults, Australia
Introduction: Asthma poses a significant burden for the Australian population. Understanding severe exacerbation rates, and steroid-related burden for adults diagnosed with asthma stands to offer insights into how this could be reduced. Methods: Electronic medical records (EMR) and questionnaires from the Optimum Patient Care Research Database Australia (OPCRDA) were utilised retrospectively. OPCRDA is a real-world database with >800,000 medical records from Australian primary care practices. Outcomes were severe asthma exacerbations in Australian adults, over a 12-month period, stratified by Global Initiative for Asthma (GINA) treatment intensity steps, and steroid associated comorbidities. Results: Of the 7868 adults treated for asthma, 19% experienced at least one severe exacerbation in the last 12-months. Severe exacerbation frequency increased with treatment intensity ([greater than or equal to]1 severe exacerbation GINA 1 13%; GINA 4 23%; GINA 5a 33% and GINA 5b 28%). Questionnaire participants reported higher rates of severe exacerbations than suggested from their EMR (32% vs 23%) especially in steps 1, 4 and 5. Patients repeatedly exposed to steroids had an increased risk of osteoporosis (OR 1.95, 95% CI 1.43-2.66) and sleep apnoea (OR 1.78, 95% CI 1.30-2.46). Conclusion: The Australian population living with GINA 1,4, 5a and 5b asthma have high severe exacerbation rates and steroid-related burden, especially when compared to other first world countries, with these patients needing alternative strategies or possibly specialist assessment to better manage their condition. Keywords: asthma, exacerbations, oral corticosteroids, adults, Australia