Morbidity from asthma in relation to regular treatment: a community based study

Area of Science:

• Respiratory Medicine
• Public Health
• Pharmacology

Background:

• Asthma morbidity prevalence in relation to treatment intensity is unclear.
• Community-based study in southern Nottinghamshire, UK.
• Focus on patients with diagnosed asthma over age four.

Purpose of the Study:

• To assess asthma morbidity in patients with varying treatment levels.
• To determine if morbidity is concentrated in low-treatment or high-treatment groups.
• To inform asthma management strategies in primary care.

Main Methods:

• Cross-sectional review of 3373 asthma patients from five general practices.
• Analysis of computerized records and prescription data (1995/6).
• Categorization of treatment by British asthma guidelines (steps 1-5).
• Morbidity measures: >=10 short-acting beta-agonist inhalers/year or oral corticosteroids/year.

Main Results:

• 54% of patients were on step 1, 22% on step 2, 11% on step 3, 3.6% on step 4, 1% on step 5, and 8% received no treatment.
• 13.6% required >=10 beta-agonist inhalers; 12.5% received oral corticosteroids.
• Higher morbidity rates observed in patients on step 3+ treatment.
• Over half of patients needing high beta-agonist doses or oral steroids were on low-dose or no inhaled corticosteroids.

Conclusions:

• Significant asthma morbidity exists in patients with minimal prophylactic treatment, suggesting a role for enhanced patient education.
• Patients with persistent asthma morbidity despite higher-level prophylactic treatment may require alternative management approaches.
• Study highlights the need to address morbidity across the spectrum of asthma treatment intensity.