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Features of Severe Asthma in Primary Care - an Observational Study
PDPI Surakarta, 03 Ags 2019 10:33:02


Aim: To investigate prevalence, management and disease control in severe asthma in Sweden.

Method: Patients ≥18 years with a drug collection for obstructive pulmonary disease during 2011 – 2012 and diagnosed asthma (ICD-10 J45-J46) were identified (index). Primary care medical records were linked to national Swedish health registries. Severe asthma classified as collection of inhaled steroid >800 budesonide or equivalent + leukotriene receptor antagonist and/or long-acting beta-agonist. Poor asthma control defined as collection of ≥600 doses of short-acting beta2-agonists per year, or any exacerbation (asthma-related hospitalizations, emergency visits and/or collection of oral steroids). Data adjusted for age.

Results: Of 18724 asthma patients, severe asthma was identified in 790 patients (4.2%). Mean age 56.9 years compared to 48.8 years in the mild-moderate asthma group (p<0.001). FEV1 % pred was 67.5% vs 83.6% (p<0.001), respectively. Asthma related yearly visits were more frequent in the severe asthma group, in primary care 31% vs 21% (p <0.001); specialist care 21% vs 7% (p<0.001). Risk of acute exacerbations was higher in the severe asthma group (100 events per 100 patient years) than the mild-moderate group (34 events per 100 patient years; relative risk [95 %CI] 2.59 [2.41-2.79]; p<0.001). One-year post index, poor asthma control was observed in 53.6% of patients in the severe group vs 28.2% in the mild-moderate group (<0.001).

Conclusion: In this asthma population, a minority of the severe asthma patients had contact with specialist care and half of the patients had poor asthma control, indicating suboptimal management and substantial under treatment of severe asthma.

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