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Asthma control in Australia: a cross-sectional web-based survey in a nationally representative population

Helen K Reddel, Susan M Sawyer, Peter W Everett, Paul V Flood and Matthew J Peters
Med J Aust 2015; 202 (9): 492-496. || doi: 10.5694/mja14.01564

Summary

Objective: To identify patterns of asthma control and treatment in Australian adults with asthma.

Design: Cross-sectional web-based survey, conducted 1–27 November 2012.

Participants: Adults with current asthma, at least 16 years of age, drawn randomly from a web-based panel and weighted to reflect national population proportions for people with asthma.

Main outcome measures: Asthma Control Test (ACT) scores; health care utilisation; medication use.

Results: 2686 participants completed the survey (57.1% female; median age group, 40-49 years). Mean ACT score was 19.2 (95% CI, 18.9–19.3), with asthma classified as “well controlled” for 54.4% of participants, “not well controlled” for 22.7% and “very poorly controlled” for 23.0%. 60.8% reported using preventer medication (mostly combined inhaled corticosteroid/long-acting β2-agonist) during the previous year. 23.4% had made at least one urgent visit to a general practitioner concerning their asthma, 10.0% at least one emergency department visit. Urgent consultations were more common for “very poorly controlled” than “well controlled” asthma (adjusted odds ratio, urgent GP visits 5.98 [95% CI, 4.75–7.54] and emergency department visits 2.59 [95% CI, 1.91–3.53] respectively).

Participants were classified according to asthma symptom control and frequency of preventer medication usage: Those with “well controlled” asthma included Group A (40.0% of participants) who used preventer medication infrequently (less than 5 days a week) or not at all, consistent with mild asthma, and Group B (14.7%), who used it at least 5 days a week. Uncontrolled asthma symptoms were reported by Group C (19.7%) despite regular preventer use, and by Group D (25.7%), who used none or little.

Conclusions: This study provides the first data about asthma control and its relationship with treatment in a large representative Australian population. The findings highlight significant preventable asthma morbidity in Australia.

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  • Helen K Reddel1
  • Susan M Sawyer2,0,3,0,4
  • Peter W Everett5
  • Paul V Flood5,0,0,6
  • Matthew J Peters7

  • 1 Woolcock Institute of Medical Research, University of Sydney, NSW.
  • 2 Centre for Adolescent Health, Royal Children's Hospital, Melbourne, VIC.
  • 3 University of Melbourne, Melbourne, VIC.
  • 4 Murdoch Childrens Research Institute, Melbourne, VIC.
  • 5 InSync Surveys, Melbourne, VIC.
  • 6 Frontrow Research, Melbourne, VIC.
  • 7 Concord Repatriation General Hospital, Sydney, NSW.


Acknowledgements: 

The survey, statistical analysis and logistical support for investigator meetings were funded by AstraZeneca. The survey was hosted and data analysed by Ultrafeedback/InSync Surveys. The investigators were independently responsible for the final methods, questionnaire design, analysis plan and interpretation. We had full access to all study data, including statistical reports and tables. The manuscript was drafted by Helen Reddel, and all authors contributed to the discussion and editing of the final version. We acknowledge the contribution of Anne Mulham (deceased), Susan Miller and Ellen Vasiliauskas who were instrumental in the conception and execution of the background qualitative research and in this survey. We acknowledge the assistance of John Lipscomb of InSync Surveys for additional statistical analysis.

Competing interests:

Helen Reddel and Matthew Peters have received honoraria for their memberships of committees and the provision of independent medical education for several companies that manufacture asthma medications, and Helen Reddel has also received unrestricted research grants from AstraZeneca and GlaxoSmithKline.

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