Insights into frequent asthma exacerbations from a primary care perspective and the implications of UK National Review of Asthma Deaths recommendations

NPJ Primary Care Respiratory Medicine
Jieqiong Freda YangWai-Ting Nicola Lee

Abstract

The United Kingdom National Review of Asthma Deaths (NRAD) recommends that patients who require ≥3 courses of oral corticosteroids (OCS) for exacerbations in the past year or those on British Thoracic Society (BTS) Step 4/5 treatment must be referred to a specialist asthma service. The aim of the study was to identify the proportion of asthma patients in primary care that fulfil NRAD criteria for specialist referral and factors associated with frequent exacerbations. A total of 2639 adult asthma patients from 10 primary care practices in Glasgow, UK were retrospectively studied between 2014 and 2015. Frequent exacerbators and short-acting β2-agonist (SABA) over-users were identified if they received ≥2 confirmed OCS courses for asthma and ≥13 SABA inhalers in the past year, respectively. Community dispensing data were used to assess treatment adherence defined as taking ≥75% of prescribed inhaled corticosteroid (ICS) dose. The study population included 185 (7%) frequent exacerbators, 137 (5%) SABA over-users, and 319 (12%) patients on BTS Step 4/5 treatment. Among frequent exacerbators, 41% required BTS Step 4/5 treatment, 46% had suboptimal ICS adherence, 42% had not attended an asthma review in the past year and 42% had no pr...Continue Reading

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Citations

Apr 22, 2020·NPJ Primary Care Respiratory Medicine·Phillip OliverCaroline Mitchell
Feb 16, 2021·Advances in Therapy·Alan G KaplanUNKNOWN Global Policy Steering Group on Improving Asthma Outcomes
Jun 29, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Tetyana KendzerskaUNKNOWN Canadian Respiratory Research Network
Jul 22, 2021·Journal of Asthma and Allergy·Anna Jetske BaronJanwillem W H Kocks
Aug 28, 2021·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Narmeen MallahBahi Takkouche

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