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 Carter; Kiranjeet Dhillon; Florian Heraud; Thao Le; Rebecca Vella; David Price; OPCA Improving Asthma outcomes in Australia Research Group

doi:10.2147/POR.S360044

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

Macquarie Medical School

Research output: Contribution to journal › Article › peer-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 language	English
Pages (from-to)	43-58
Number of pages	16
Journal	Pragmatic and Observational Research
Volume	13
DOIs	https://doi.org/10.2147/POR.S360044
Publication status	Published - 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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10.2147/POR.S360044Licence: CC BY-NC

Publisher version (open access)Final published version, 2.11 MBLicence: CC BY-NC

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Hancock, K. L., Bosnic-Anticevich, S., Blakey, J. D., Hew, M., Chung, L. P., Cvetkovski, B., Claxton, S., Del Fante, P., Denton, E., Doan, J., Ranasinghe, K., Morgan, L., Sharma, A., Smith, P. K., Stewart, D., Thompson, P. J., Wiseman, R., Upham, J. W., Yan, K. Y., ... OPCA Improving Asthma outcomes in Australia Research Group (2022). Characterisation of the Australian adult population living with asthma: severe-exacerbation frequency, long-term OCS use and adverse effects. Pragmatic and Observational Research, 13, 43-58. https://doi.org/10.2147/POR.S360044

@article{2a7d150fecbf4f489ce8cdf4779d6f0b,

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

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.",

keywords = "asthma, exacerbations, oral corticosteroids, adults, Australia",

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

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.",

year = "2022",

doi = "10.2147/POR.S360044",

language = "English",

volume = "13",

pages = "43--58",

journal = "Pragmatic and Observational Research",

issn = "1179-7266",

publisher = "Dove Medical Press Ltd.",

}

Hancock, KL, Bosnic-Anticevich, S, Blakey, JD, Hew, M, Chung, LP, Cvetkovski, B, Claxton, S, Del Fante, P, Denton, E, Doan, J, Ranasinghe, K, Morgan, L, Sharma, A, Smith, PK, Stewart, D, Thompson, PJ, Wiseman, R, Upham, JW, Yan, KY, Carter, V, Dhillon, K, Heraud, F, Le, T, Vella, R, Price, D & OPCA Improving Asthma outcomes in Australia Research Group 2022, 'Characterisation of the Australian adult population living with asthma: severe-exacerbation frequency, long-term OCS use and adverse effects', Pragmatic and Observational Research, vol. 13, pp. 43-58. https://doi.org/10.2147/POR.S360044

TY - JOUR

T1 - Characterisation of the Australian adult population living with asthma

T2 - severe-exacerbation frequency, long-term OCS use and adverse effects

AU - Hancock, Kerry L.

AU - Bosnic-Anticevich, Sinthia

AU - Blakey, John D.

AU - Hew, Mark

AU - Chung, Li Ping

AU - Cvetkovski, Biljana

AU - Claxton, Scott

AU - Del Fante, Peter

AU - Denton, Eve

AU - Doan, Joe

AU - Ranasinghe, Kanchanamala

AU - Morgan, Lucy

AU - Sharma, Anita

AU - Smith, Peter K.

AU - Stewart, Deb

AU - Thompson, Philip J.

AU - Wiseman, Russell

AU - Upham, John W.

AU - Yan, Kwok Y.

AU - Carter, Victoria

AU - Dhillon, Kiranjeet

AU - Heraud, Florian

AU - Le, Thao

AU - Vella, Rebecca

AU - Price, David

AU - OPCA Improving Asthma outcomes in Australia Research Group

N1 - 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.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - asthma

KW - exacerbations

KW - oral corticosteroids

KW - adults

KW - Australia

U2 - 10.2147/POR.S360044

DO - 10.2147/POR.S360044

M3 - Article

C2 - 35818499

SN - 1179-7266

VL - 13

SP - 43

EP - 58

JO - Pragmatic and Observational Research

JF - Pragmatic and Observational Research

ER -

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

Abstract

Bibliographical note

Keywords

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