Abstract
Some patients with asthma experience frequent exacerbations despite standard pharmacotherapy. Previous exacerbations and poor symptom control are known predictors of exacerbations, but other patient characteristics recorded within routine primary care electronic medical records (EMRs) may also help identify patients at risk of future exacerbations.
Methods: Anonymised EMRs were extracted from the Optimum Patient Care Research Database (data from 311 UK practices from 2005-2010). Eligible patients (aged 12–80 yrs) had: clinician-diagnosed asthma; ≥3 yrs continuous data (1 baseline and 2 outcome years); and ≥1 asthma prescription during baseline. The association between baseline demographic and clinical characteristics, and frequent (≥2 and ≥4) severe exacerbations (asthma-related: oral corticosteroids and/or hospitalisations) during outcome was modelled using hierarchical logistic regression.
Results: There were 93,188 eligible patients, mean age 44 (standard deviation 18) yrs. Independent factors significantly associated with frequent exacerbations are summarised (Table 1).
Conclusion: Multiple exacerbations are common, often despite frequent primary care consultations and increased ICS therapy. Identifying high-risk patients using EMRs is feasible and may facilitate targeted interventions.
- Copyright ©ERS 2015