Western Australia and parts of the Northern Territory and Tasmania have been identified as asthma “hot spots” recording the highest numbers of people with difficult to treat asthma in Australia, in a study published in the Journal of Asthma.
The study also found the greatest prevalence of severe uncontrolled asthma and/or more frequent use of oral corticosteroids (OCS) was observed in South Australia and parts of Queensland and New South Wales.
National Asthma Council Australia Director and respiratory physician Professor Peter Wark, lead author of the paper, said the concern is that this represents a problem with access to care in rural areas.
“Despite global and national guidelines, regional differences in the prevalence of severe asthma, severe uncontrolled asthma and oral corticosteroid use exist in Australia.
“The study identified important variations across the country both by state and geography and it is our hope that understanding regional variation may inform policy and target treatment to areas with the greatest unmet need.
While the reason for the wide variation isn’t clear, Professor Wark said it is likely to be due to a number of factors.
“This includes environmental and socioeconomic issues in relation to air quality and potentially access to healthcare. In the case of both Western Australia and the Northern Territory, remoteness is also an important factor,” said Professor Wark.
The study also found overuse of high-dose inhaled corticosteroids (ICS)/long-acting beta-agonist (LABA) with poor adherence and asthma control and an alarming number of people exposed to high dose cumulative OCS over just a 12-month period.
“Given what we know about the efficacy of both inhaled corticosteroids we are clearly not achieving the types of asthma control that we should and those individuals are at high risk of long-term complications from the use of corticosteroids.
“We have serious challenges implementing effective asthma management in Australia, likely due to a combination of factors including adherence to treatment, the use of devices and over reliance on prescribing oral corticosteroids. It is also likely that too few people are being referred for assessment of severe asthma and consideration of biologic therapies,” he said.
Professor Wark said that the next step would be to drill down into the reasons behind the regional variation in asthma control, including the combination of environmental exposures, socioeconomic factors and access to healthcare.
“What is obvious is that this is not a small problem, as the data analysed represented 1.9 million Australians and 24% had difficult to control disease.
“This highlights the fact that asthma remains a very serious chronic health condition for the Australian population despite access to medications that should be highly effective,” said Professor Wark.
Note to editor:
The study used the NostraData longitudinal database to obtain de-identified, patient-level, prescription data from approximately 4,500 (82%) community pharmacies in Australia from March 2018 to February 2019.
340 geographic areas, defined per Statistical Area 3 (SA3), were used to determine regional prevalence through heat maps. SA3s are geographical areas with populations generally between 30,000 to 130,000 persons.
Asthma is more prevalent in inner regional, outer regional, and remote regions (up to 12.9%) vs. major cities (10.6%)[1] and an estimated 52,800 to 176,000 Australians (0.2%–0.7%) have severe asthma[2].
For further information or an interview with Professor Wark, please contact:
Donna Le Page, Le Page PR
Mobile: 0429 825 703
Email: [email protected]
References
[1] Main Features - Asthma. Australian Bureau of Statistics, Australian Government.
https://www.abs.gov au/ausstats/abs.nsf/Lookup/bySubject/4364.0.55.001~2017-18~Main Features~Asthma~35. Accessed February 4, 2020
[2] Centre of Excellence in Severe Asthma. Centre of Excellence in Severe Asthma. https://www.severeasthma.org.au/. Published August 2, 2019. Accessed February 4, 2020.
Access the full study: https://www.tandfonline.com/doi/full/10.1080/02770903.2022.2093217
Source: (2023) Regional variation in prevalence of difficult-to-treat asthma and oral corticosteroid use for patients in Australia: heat map analysis, Journal of Asthma, 60:4, 727-736, DOI: 10.1080/02770903.2022.2093217
