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轻度哮喘的负担:NOVELTY 研究中的临床负担和医疗资源利用。

The burden of mild asthma: Clinical burden and healthcare resource utilisation in the NOVELTY study.

机构信息

GMAP, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.

Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.

出版信息

Respir Med. 2022 Aug-Sep;200:106863. doi: 10.1016/j.rmed.2022.106863. Epub 2022 May 9.

DOI:10.1016/j.rmed.2022.106863
PMID:35952579
Abstract

BACKGROUND

Patients with mild asthma represent a substantial proportion of the population with asthma, yet there are limited data on their true burden of disease. We aimed to describe the clinical and healthcare resource utilisation (HCRU) burden of physician-assessed mild asthma.

METHODS

Patients with mild asthma were included from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329), a global, 3-year, real-world prospective study of patients with asthma and/or chronic obstructive pulmonary disease from community practice (specialised and primary care). Diagnosis and severity were based on physician discretion. Clinical burden included physician-reported exacerbations and patient-reported measures. HCRU included inpatient and outpatient visits.

RESULTS

Overall, 2004 patients with mild asthma were included; 22.8% experienced ≥1 exacerbation in the previous 12 months, of whom 72.3% experienced ≥1 severe exacerbation. Of 625 exacerbations reported, 48.0% lasted >1 week, 27.7% were preceded by symptomatic worsening lasting >3 days, and 50.1% required oral corticosteroid treatment. Health status was moderately impacted (St George's Respiratory Questionnaire score: 23.5 [standard deviation ± 17.9]). At baseline, 29.7% of patients had asthma symptoms that were not well controlled or very poorly controlled (Asthma Control Test score <20), increasing to 55.6% for those with ≥2 exacerbations in the previous year. In terms of HCRU, at least one unscheduled ambulatory visit for exacerbations was required by 9.5% of patients, including 9.2% requiring ≥1 emergency department visit and 1.1% requiring ≥1 hospital admission.

CONCLUSIONS

In this global sample representing community practice, a significant proportion of patients with physician-assessed mild asthma had considerable clinical burden and HCRU.

摘要

背景

轻度哮喘患者在哮喘患者中占很大比例,但关于其疾病真实负担的数据有限。我们旨在描述经医生评估的轻度哮喘的临床和医疗资源利用(HCRU)负担。

方法

从全球、3 年、真实世界的社区实践(专科和初级保健)中哮喘和/或慢性阻塞性肺疾病患者的 NOVEL 观察性纵向研究(NOVELTY;NCT02760329)中纳入轻度哮喘患者。诊断和严重程度基于医生的判断。临床负担包括医生报告的加重和患者报告的测量。HCRU 包括住院和门诊就诊。

结果

共纳入 2004 例轻度哮喘患者;22.8%的患者在过去 12 个月中经历过≥1 次加重,其中 72.3%经历过≥1 次重度加重。报告的 625 次加重中,48.0%持续时间超过 1 周,27.7%加重前有持续>3 天的症状恶化,50.1%需要口服皮质类固醇治疗。健康状况受到中度影响(圣乔治呼吸问卷评分:23.5[标准差±17.9])。基线时,29.7%的患者哮喘症状控制不佳或很差(哮喘控制测试评分<20),在过去 1 年有≥2 次加重的患者中,这一比例增加到 55.6%。就 HCRU 而言,9.5%的患者需要至少一次因加重而进行的非计划性门诊就诊,包括 9.2%需要至少 1 次急诊就诊和 1.1%需要至少 1 次住院治疗。

结论

在这个代表社区实践的全球样本中,相当一部分经医生评估的轻度哮喘患者有相当大的临床负担和 HCRU。

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