Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK.
Paediatric Severe Asthma Group, Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.
Eur Respir J. 2019 Apr 4;53(4). doi: 10.1183/13993003.02130-2018. Print 2019 Apr.
Asthma is the most common respiratory disorder in the UK, yet we have incomplete knowledge on the prevalence of current disease, treatment and exacerbations.We used UK electronic healthcare records, 2006-2016, to estimate the prevalence of current asthma by year, sex and age (<5, 5-11, 12-17, 18-24, 25-54 and ≥55 years), and the proportion prescribed inhaled corticosteroids (ICS) and additional asthma therapy, treated for exacerbations and other asthma care markers.Overall current asthma prevalence was 6.5% in 2016 (7.2% in 2006). Prevalence fell in those aged <45 years. The lowest prevalence and largest absolute decrease was in children aged <5 years. In 2016, 80% of current asthma patients were managed on ICS (65% in 2006); this increase occurred in all age groups, primarily due to an increase in low-dose ICS. During this time there was an increase in all age groups in the proportion prescribed additional asthma therapy, treated for an exacerbation within primary care and given an annual asthma review or management plan. Hospitalised exacerbations showed minimal change over time.Asthma remains highly prevalent and a significant healthcare burden. In those with a diagnosis, there was an increase in ICS prescriptions and treatment of exacerbations across all age groups. This may reflect a trend towards more aggressive asthma management within primary care. An apparent decline in prevalence was observed in those aged <45 years, particularly in children aged <5 years.
哮喘是英国最常见的呼吸道疾病，但我们对当前疾病的患病率、治疗方法和加重情况了解不完整。我们使用英国电子医疗记录（2006-2016 年），按年、性别和年龄（<5 岁、5-11 岁、12-17 岁、18-24 岁、25-54 岁和≥55 岁）估算当前哮喘的患病率，并估算处方吸入性皮质类固醇（ICS）和附加哮喘治疗、治疗加重和其他哮喘护理标志物的比例。2016 年当前哮喘的总体患病率为 6.5%（2006 年为 7.2%）。45 岁以下人群的患病率下降。患病率最低且绝对值下降最大的是<5 岁的儿童。2016 年，80%的当前哮喘患者接受 ICS 治疗（2006 年为 65%）；所有年龄组的这一比例都有所增加，主要是由于低剂量 ICS 的使用增加。在此期间，所有年龄组接受附加哮喘治疗、在初级保健中治疗加重、接受年度哮喘检查或管理计划的患者比例均有所增加。住院加重的情况在这段时间内基本没有变化。哮喘仍然高度流行，是一个重大的医疗保健负担。在有诊断的患者中，所有年龄组的 ICS 处方和加重治疗都有所增加。这可能反映出初级保健中更积极的哮喘管理趋势。在<45 岁的人群中，尤其是<5 岁的儿童中，观察到患病率下降。
