Clinical Characteristics and Economic Burden of Asthma in China: A Multicenter Retrospective Study
-
Bin Shang
,
Xiangguo Li
,
Yu Xu
,
Wenxin Ren
,
Junren Wang
,
Chunyan Xing
,
Shujuan Jiang
,
Jian Sun
Abstract
Asthma is a common chronic airway inflammation that produces a healthcare burden on the economy. We aim to obtain a better understanding of the clinical status and disease burden of patients with asthma in China.
A retrospective study was carried out based on the computerized medical records in the Jinan Health Medical Big Data Platform between 2011 and 2019 (available data from 38 hospitals). The asthma severity of each patient was assessed retrospectively and categorized as mild, moderate, or severe according to Global Initiative for Asthma 2020 (GINA 2020).
The results revealed that the majority (75.0%) of patients suffered from mild asthma. Patients treated with inhaled corticosteroids (ICS)/long-acting beta-agonists (LABA) at emergency department visits had lower frequencies of exacerbations compared with non-ICS/LABA-treated patients. The incidence rates for 1, 2, 3, and 4 exacerbation of the patients treated with ICS/LABA are lower than those treated without ICS/LABA (14.49 vs. 15.01%, 11.94% vs. 19.12%, 6.51% vs.12.92% and 4.10% vs. 9.35%). The difference got a statistical significance Chronic obstructive pulmonary disease (COPD) and gastroesophageal reflux disease (GERD), two comorbidities related to asthma, were risk factors for asthma exacerbation. Finally, patients who suffered from exacerbations produced a heavier economic burden compared to the patients who never suffered exacerbations (mean costs are ￥3,339.67 vs. ￥968.45 separately).
These results provide a reference for clinicians and patients to obtain a better treatment and therapy strategy management for people living with asthma.
2. Myers TR, Tomasio L. Asthma: 2015 and beyond. Respir Care. 2011;56(9):1389-407; discussion 407-10.
3. Thomsen SF. Genetics of asthma: an introduction for the clinician. Eur Clin Respir J. 2015;2.
4. Masoli M, Fabian D, Holt S, Beasley R, Global Initiative for Asthma P. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59(5):469-78.
5. Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet. 2019;394(10196):407-18.
6. Ivanova JI, Bergman R, Birnbaum HG, Colice GL, Silverman RA, McLaurin K. Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma. J Allergy Clin Immunol. 2012;129(5):1229-35.
7. Sadatsafavi M, Rousseau R, Chen W, Zhang W, Lynd L, FitzGerald JM. The preventable burden of productivity loss due to suboptimal asthma control: a population-based study. Chest. 2014;145(4):787-93.
8. Kaur R, Chupp G. Phenotypes and endotypes of adult asthma: Moving toward precision medicine. J Allergy Clin Immunol. 2019;144(1):1-12.
9. Ulrich L, Palacios S. Asthma Self-management: It's Not One Size Fits All. Immunol Allergy Clin North Am. 2019;39(4):573-82.
10. Suau SJ, DeBlieux PM. Management of Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease in the Emergency Department. Emerg Med Clin North Am. 2016;34(1):15-37.
11. Jayakumaran J, Hunter K, Roy S. Outpatient Management of Bronchial Asthma: A Comparative Analysis Between Guideline-Directed Management and Usual Management. J Clin Med Res. 2020;12(6):362-8.
12. Ding B, DiBonaventura M, Karlsson N, Ling X. A cross-sectional assessment of the prevalence and burden of mild asthma in urban China using the 2010, 2012, and 2013 China National Health and Wellness Surveys. J Asthma. 2017;54(6):632-43.
13. Dhar R, Ip M, Kulkarni T, Kim SH, Perng DW, Yao X, et al. Challenges faced in managing adult asthma: A perspective from Asian countries. Respirology. 2020;25(12):1235-42.
14. Macy E, Yao JF, Chen W. Fatal Asthma: An Audit of 30 Million Patient-Years of Health Plan Membership from 2007 to 2015. J Allergy Clin Immunol Pract. 2019;7(2):597-605.
15. Gershon AS, Wang C, Guan J, To T. Burden of comorbidity in individuals with asthma. Thorax. 2010;65(7):612-8.
16. Harding SM, Guzzo MR, Richter JE. 24-h esophageal pH testing in asthmatics: respiratory symptom correlation with esophageal acid events. Chest. 1999;115(3):654-9.
17. Sontag SJ, O'Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, et al. Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. Gastroenterology. 1990;99(3):613-20.
18. Harding SM, Guzzo MR, Richter JE. The prevalence of gastroesophageal reflux in asthma patients without reflux symptoms. Am J Respir Crit Care Med. 2000;162(1):34-9.
19. Desai M, Oppenheimer J, Tashkin DP. Asthma-chronic obstructive pulmonary disease overlap syndrome: What we know and what we need to find out. Ann Allergy Asthma Immunol. 2017;118(3):241-5.
20. Balanag VM, Yunus F, Yang PC, Jorup C. Efficacy and safety of budesonide/formoterol compared with salbutamol in the treatment of acute asthma. Pulm Pharmacol Ther. 2006;19(2):139-47.
21. Ding B, Small M. Disease burden of mild asthma in China. Respirology. 2018;23(4):369-77.
22. Lin J, Xing B, Tang H, Yang L, Yuan Y, Gu Y, et al. Hospitalization Due to Asthma Exacerbation: A China Asthma Research Network (CARN) Retrospective Study in 29 Provinces Across Mainland China. Allergy Asthma Immunol Res. 2020;12(3):485-95.
23. Nurmagambetov T, Kuwahara R, Garbe P. The Economic Burden of Asthma in the United States, 2008-2013. Ann Am Thorac Soc. 2018;15(3):348-56.
| Files | ||
| Issue | Vol 22 No 3 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v22i3.13057 | |
| Keywords | ||
| Asthma Economic burden Retrospective study | ||
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