Age- and sex-specific prevalence of chronic comorbidity in adult patients with asthma: A real-life study

Abstract

The presence of comorbidity can be associated with poorer asthma outcomes. Previous prevalence studies focused on a limited selection of comorbid conditions in asthma only. We aimed to determine age- and sex-specific prevalence estimates for the full range of chronic comorbid conditions in adult asthma patients by performing a retrospective cohort study based on 32,787 medical records of patients aged ≥16 years with asthma from 179 general practices in the Netherlands. Age- and sex-specific prevalence estimates of 76 chronic comorbidities and 14 disease categories based on International Classification of Primary Care codes were determined. Chronic comorbidity was present in 65.3% of male asthma patients and 72.8% of female asthma patients, with female patients having a higher mean (SD) of 2.0 (2.1) comorbidities compared to male patients (1.7 (2.0)). This mean increased to 5.0 (2.7) conditions in the 75+ age group. Most prevalent comorbidities were hypertension (20.1%), osteoarthritis (11.5%), eczema (11.5%) and dyspepsia (10.7%). Compared to male asthma patients, female asthma patients showed higher odds for the presence of other chronic conditions in eight disease categories. Neurological (odds ratio [OR]; 95% confidence interval 2.01; 1.76–2.29), blood forming/lymphatics (OR 1.83; 1.38–2.42) and musculoskeletal diseases (OR 1.82; 1.69–1.95) showed the highest association with female sex. In conclusion, the presence of chronic comorbidity is the norm in adults with asthma and it is more prevalent in female than in male asthma patients. The odds of having a specific comorbid condition may differ between the sexes. Attention in guidelines on how to handle comorbidities may lead to a more targeted treatment for comorbidities and more patient-centred asthma management.

Epidemiology of comorbidities and their association with asthma control

“…The higher proportion of female patients and the different prevalence of certain comorbidities are both well-documented aspects of asthmatic populations [ 4 , 20 – 23 ]. Veenendaal et al [ 20 ] examined the prevalence of comorbidities of more than 32,000 asthmatic patients and showed that females are affected by overall comorbidities at a higher rate compared with males, with significant differences in certain disease categories.…”

“…The higher proportion of female patients and the different prevalence of certain comorbidities are both well-documented aspects of asthmatic populations [ 4 , 20 – 23 ]. Veenendaal et al [ 20 ] examined the prevalence of comorbidities of more than 32,000 asthmatic patients and showed that females are affected by overall comorbidities at a higher rate compared with males, with significant differences in certain disease categories. Other studies have also presented a significant gender-related difference in certain comorbidities, including hypertension, cardiovascular diseases, depression, osteoporosis, and allergic diseases [ 21 – 23 ].…”

Emotional distress and quality of life in allergic diseases

“…Research shows that one of the most important factors of repeated exacerbations are mental disorders [8]. The most common psychiatric disorders observed in patients with asthma are mood disorders, depression, anxiety disorders and alcohol abuse [9,10]. Due to the frequent coexistence with asthma of psychiatric disorders, it is difficult to conclude whether asthma may increase the probability of psychiatric disorders or mental disorders may lead to asthma exaxerbation [5,11].…”

Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma

“…However, according to Braido et al [3], up to 56% of patients do not have a proper level of disease control. One of the significant obstacles to achieving BA control is the presence of comorbid conditions [4][5][6][7][8].…”

“…However, according to Braido et al [ 3 ], up to 56% of patients do not have a proper level of disease control. One of the significant obstacles to achieving BA control is the presence of comorbid conditions [ 4 – 8 ]. In the list of common variants of comorbidity in recent years, close attention is focused on the combination of BA and obesity [ 9 ].…”