The impact of poor asthma control among asthma patients treated with inhaled corticosteroids plus long-acting β 2 -agonists in the United Kingdom: a cross-sectional analysis

摘要

There are several new treatment options for patients whose asthma remains uncontrolled on free-dose and fixed-dose combinations of inhaled corticosteroids plus long-acting 尾2-agonists (ICS+LABA). In order to evaluate the likely impact of these treatments, we assessed the effect of uncontrolled asthma on healthcare and patient burden within the UK among adult patients treated with ICS+LABA. Data obtained from 2010鈥?011 UK National Health and Wellness Surveys identified 701 patients treated with ICS+LABA. Patients with not well-controlled asthma (Asthma Control Test鈩?score <20) were compared with well-controlled asthma (score鈥夆墺鈥?0) patients on multiple measures. Cost burden was calculated using healthcare resource utilisation models and work productivity and impairment questionnaire. Overall, 452 and 249 patients reported not well-controlled and well-controlled asthma, respectively. A greater proportion of not well-controlled patients visited the accident & emergency department (21 vs. 14%, P鈥?鈥?.016), were hospitalised (13 vs. 8%, P鈥?鈥?.022) and had lower mental and physical health-related quality of life (P鈥?鈥?.001) and impaired work productivity and activity scores: presenteeism (23 vs. 11%, P鈥?鈥?.001), work impairment (29 vs. 17%, P鈥?鈥?.001) and activity impairment (46 vs. 24%, P鈥?鈥?.001). Calculated direct and indirect yearly costs/person doubled among not well-controlled compared to well-controlled asthma patients (拢6592 vs. 拢3220). Total cost to society was estimated at 拢6172 million/year (direct costs, 拢1307 million; indirect costs, 拢4865 million). In conclusion, not well-controlled asthma is common among UK adults treated with ICS+LABA, resulting in impairments across a number of important health outcomes and represents a significant unmet need and resource burden.