Characterisation of the Australian adult population living with asthma: severe-exacerbation frequency, long-term OCS use and adverse effects

Kerry L. Hancock, Sinthia Bosnic-Anticevich, John D. Blakey, Mark Hew, Li Ping Chung, Biljana Cvetkovski, Scott Claxton, Peter Del Fante, Eve Denton, Joe Doan, Kanchanamala Ranasinghe, Lucy Morgan, Anita Sharma, Peter K. Smith, Deb Stewart, Philip J. Thompson, Russell Wiseman, John W. Upham, Kwok Y. Yan, Victoria CarterKiranjeet Dhillon, Florian Heraud, Thao Le, Rebecca Vella, David Price*, OPCA Improving Asthma outcomes in Australia Research Group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

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 (≥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.

Original languageEnglish
Pages (from-to)43-58
Number of pages16
JournalPragmatic and Observational Research
Volume13
DOIs
Publication statusPublished - 2022

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • asthma
  • exacerbations
  • oral corticosteroids
  • adults
  • Australia

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