Inappropriate asthma therapy-a tale of two countries: a parallel population-based cohort study

Manon Belhassen, Anjan Nibber, Eric Van Ganse, Dermot Ryan, Carole Langlois, Francis Appiagyei, Derek Skinner, Laurent Laforest, Joan B Soriano, David Price

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Abstract

Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases. Patients aged 6-40 years were studied over the 12-month period following inclusion, regarding overuse (⩾12 units) of SABA, use of LABA without inhaled corticosteroids (ICS) and ⩾2-fold higher use of LABA compared with that of ICS. Overall, 39,743 UK and 4,910 French patients were included in 2007, and 14,036 and 5,657 patients, respectively, were included in 2013. UK adults were more frequently exposed to SABA overuse compared with those in France in both periods, with an upward trend in the United Kingdom (P<0.05). In 2013, LABA use without ICS occurred in 0.1% and 1.5% of United Kingdom and French adults, respectively. Unbalanced use of LABA relative to ICS became marginal in both countries in 2013. Inappropriate use of therapy was less marked, but present, in children. Inappropriate therapy remains a common issue in asthma. Based on our figures, it may be estimated that >210,000 British and >190,000 French asthmatics aged 6-40 years were inappropriately treated in 2013.

Original languageEnglish
Article number16076
Journalnpj Primary Care Respiratory Medicine
Volume26
DOIs
Publication statusPublished - 13 Oct 2016

Keywords

  • epidemiology
  • public health

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    Belhassen, M., Nibber, A., Van Ganse, E., Ryan, D., Langlois, C., Appiagyei, F., Skinner, D., Laforest, L., Soriano, J. B., & Price, D. (2016). Inappropriate asthma therapy-a tale of two countries: a parallel population-based cohort study. npj Primary Care Respiratory Medicine, 26, [16076]. https://doi.org/10.1038/npjpcrm.2016.76