Level of asthma control and health care utilization in Asia-Pacific countries

Gold, Laura S.; Thompson, Phillip; Salvi, Sundeep; Faruqi, Rab; Sullivan, Sean D.

doi:10.1016/j.rmed.2013.12.004

Cited by 61 publications

(77 citation statements)

References 14 publications

(13 reference statements)

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“…Our study used the count of health care visits from NHRI databases as the measure of morbidity in the population. Clinic visits, outpatient visits, ED visits and admissions are types of health care service, but also possessed of potentially important disparities [17,18]. Because asthma is a chronic disease, patients with asthma were taught to deal with their symptoms and discomfort of an asthma attack [19,20].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Air Pollution on Outpatient and Inpatient Visits for Asthma: A Population-Based Study in Taiwan

et al. 2014

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BackgroundA nationwide asthma survey on the effects of air pollution is lacking in Taiwan. The purpose of this study was to evaluate the time trend and the relationship between air pollution and health care services for asthma in Taiwan.MethodsHealth care services for asthma and ambient air pollution data were obtained from the National Health Insurance Research database and Environmental Protection Administration from 2000 through 2009, respectively. Health care services, including those related to the outpatient and inpatient visits were compared according to the concentration of air pollutants.ResultsThe number of asthma-patient visits to health-care facilities continue to increase in Taiwan. Relative to the respective lowest quartile of air pollutants, the adjusted relative risks (RRs) of the outpatient visits in the highest quartile were 1.10 (P-trend = 0.013) for carbon monoxide (CO), 1.10 (P-trend = 0.015) for nitrogen dioxide (NO2), and 1.20 (P-trend <0.0001) for particulate matter with an aerodynamic diameter ≦10µm (PM10) in the child group (aged 0–18). For adults aged 19–44, the RRs of outpatient visits were 1.13 (P-trend = 0.078) for CO, 1.17 (P-trend = 0.002) for NO2, and 1.13 (P-trend <0.0001) for PM10. For adults aged 45–64, the RRs of outpatient visits were 1.15 (P-trend = 0.003) for CO, 1.19 (P-trend = 0.0002) for NO2, and 1.10 (P-trend = 0.001) for PM10. For the elderly (aged≥ 65), the RRs of outpatient visits in were 1.12 (P-trend = 0.003) for NO2 and 1.10 (P-trend = 0.006) for PM10. For inpatient visits, the RRs across quartiles of CO level were 1.00, 1.70, 1.92, and 1.86 (P-trend = 0.0001) in the child group. There were no significant linear associations between inpatient visits and air pollutants in other groups.ConclusionsThere were positive associations between CO levels and childhood inpatient visits as well as NO2, CO and PM10 and outpatient visits.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Air Pollution on Outpatient and Inpatient Visits for Asthma: A Population-Based Study in Taiwan

et al. 2014

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“…The International Severe Asthma Registry reports that 59.6% of severe asthma patients in the UK were prescribed OCS maintenance treatment, while fewer patients used OCS in the USA (23.3%), South Korea (20.7%) and Italy (5.2%) (unpublished data presented at 2018 Respiratory Effectiveness Group Summit). Some retrospective studies report higher but variable OCS usage rates across different regions of the world (Table S1 in Supplementary Information) …”

Section: Usage Prevalence and Burden Of Ocs In Severe Asthmamentioning

confidence: 99%

“…Selected biologics also decrease maintenance OCS use in severe asthma . However, ongoing high OCS use in severe asthma suggests these measures have not been optimally applied …”

Section: Introductionmentioning

confidence: 99%

Rational oral corticosteroid use in adult severe asthma: A narrative review

et al. 2019

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OCS play an important role in the management of asthma. However, steroid-related AE are common and represent a leading cause of morbidity. Limited published studies suggest OCS usage varies across countries and recent registry data indicate that at least 25-60% of patients with severe asthma in developed countries may at some stage be prescribed OCS. Recent evidence indicate that many patients do not receive optimal therapy for asthma and are often prescribed maintenance OCS or repeated steroid bursts to treat exacerbations. Given the recent progress in adult severe asthma and new treatment options, judicious appraisal of steroid use is merited. A number of strategies and add-on therapies are now available to treat severe asthma. These include increasing specialist referral for multidisciplinary assessments and implementing OCSsparing interventions, such as improving guideline adherence and add-on tiotropium and macrolides. Biologics have recently become available for severe asthma; these agents reduce asthma exacerbations and lower OCS exposure. Further research, collaboration and consensus are necessary to develop a structured stewardship approach including realistic OCS-weaning programmes for patients with severe asthma on regular OCS; education and public health campaigns to improve timely access to specialized severe asthma services for treatment optimization; and implementing targeted strategies to identify patients who warrant OCS use using objective biomarker-based strategies.

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“…Asthma is a common, chronic respiratory disease estimated to affect 1.0–18.0% of the population depending on the country . The 2002 prevalence estimates of 3.0–6.0% for Asia‐Pacific nations are lower compared with Western countries, although prevalence in Asia appears to be on the rise . This increase has been attributed to environmental exposures, with children and the elderly at highest risk…”

Section: Introductionmentioning

confidence: 99%