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- Title
Is higher population-level use of ICS/ LABA combination associated with better asthma outcomes? Cross-sectional surveys of nationally representative populations in New Zealand and Australia.
- Authors
Reddel, Helen K.; Beckert, Lutz; Moran, Angela; Ingham, Tristram; Ampon, Rosario D.; Peters, Matthew J.; Sawyer, Susan M.
- Abstract
ABSTRACT Background and objective New Zealand ( NZ) and Australia ( AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries. Methods A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions. Symptom control was assessed with the Asthma Control Test ( ACT). Healthcare utilization was assessed from reported urgent doctor/hospital visits in the previous year. Results NZ ( n = 537) and Australian ( n = 2686) participants had similar age and gender distribution. More NZ than Australian participants used inhaled corticosteroid ( ICS)-containing medication (68.8% vs 60.9%; P = 0.006) but ICS/long-acting β2-agonist ( LABA) constituted 44.4% of NZ and 81.5% of Australian total ICS use ( P < 0.0001). Adherence was higher with ICS/ LABA than ICS-alone ( P < 0.0001), and higher in NZ than in AU ( P < 0.0001). ACT scores were similar ( P = 0.41), with symptoms well controlled in 58.6% and 54.4% participants, respectively. More NZ participants reported non-urgent asthma reviews (56.6% vs 50.4%; P = 0.009). Similar proportions had urgent asthma visits (27.9% and 28.6%, respectively, P = 0.75). Conclusion This comparison, which included the first nationally representative data for asthma control in NZ, showed that poorly controlled asthma is common in both NZ and AU, despite subsidized ICS-containing medications. The greater use of ICS-alone in NZ relative to ICS/ LABA does not appear to have compromised population-level asthma outcomes, perhaps due to better adherence in NZ. Different ICS/ LABA subsidy criteria and different patient copayments may also have contributed to these findings.
- Subjects
ANTIASTHMATIC agents; ASTHMA treatment; EPIDEMIOLOGY research methodology; CROSS-sectional method; ADRENERGIC beta agonists; THERAPEUTICS
- Publication
Respirology, 2017, Vol 22, Issue 8, p1570
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.13123