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 7,868 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.
We wish to acknowledge and thank Sheryl Bradley, Rob Campbell, Andrew Davis, Sophie Jones, Chi Ming Lau, Ying Liu, Ian Miles, Marion Magee, Dominique Novic, John Pakos, Frank Postma, Dr Ondrej Rejda, Josephine Samuel-King, David Smallwood, Shay Soremekun, Majella Soumakiyan, Lisa Sugg, and Bruce Willet of the OPCA Improving Asthma outcomes in Australia Research Group for their valuable contributions in making this publication possible. AstraZeneca was given the opportunity to review the manuscript for medical and scientific accuracy, but the authors retained full editorial control. We wish to acknowledge Clare Ghisla, Amanda Baker, and Robin Whiteley for their academic contribution.
Writing, editorial support, and/or formatting assistance in the development of this manuscript was provided by Shilpa Suresh, MSc, of the Observational and Pragmatic Research Institute, Singapore.
- oral corticosteroids