Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales—a study protocol

Abstract

IntroductionAsthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care.Methods and analysisSecondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates.Ethics and disseminationApprovals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map.

Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population-based cohort 2006–2016

“…Survey data (using self-report of symptoms, doctor diagnosis and treatment) from the UK have found approximately double the prevalence of "asthma" in all age groups compared to our estimates [3,19,[21][22][23][24][25][26][27]. However, the four established asthma surveys that have been used in the UK define asthma by the presence of self-reported wheeze, which may be related to other factors (interpretation of "wheeze") and other pathologies, thus overestimating the presence of clinical asthma.…”

Asthma costs and social impact

“…As an example, in the UK, an initiative aiming to provide data on previously identified gaps on asthma costs was launched; its ultimate vision is to contribute to obtain valid data that allows policy changes leading to the provision of more cost-effective care [55]. …”

Defining asthma and assessing asthma outcomes using electronic health record data: a systematic scoping review

“…"Current general practitioner-reported and diagnosed asthma" was defined as any asthma encounter in the last 12 months; "current general practitioner-reported, diagnosed and treated asthma" as the same plus any asthma prescription in the same period [22].…”