Benson Victoria S, Siddall James, Haq Adam, Small Mark, Alfonso-Cristancho Rafael, Tang Zhiliu, Howarth Peter, Ye Tao, Richards Anna
Epidemiology, Value Evidence & Outcomes, GSK, London, UK.
Adelphi Real World, Bollington, UK.
J Asthma Allergy. 2024 Sep 30;17:949-964. doi: 10.2147/JAA.S460300. eCollection 2024.
To inform better asthma management in China, this study aimed to comprehensively investigate clinical characteristics, treatment patterns, asthma control status, exacerbations, and humanistic burden among adult patients seeking hospital-based asthma care by analyzing data from Adelphi Asthma Disease Specific Program conducted in China.
All information was collected on survey date (August-December 2018) from medical records, physicians, or patients, without follow-up being conducted. Results are summarized descriptively for the overall population as well as subgroups defined by GINA 2018 treatment step.
Of the included 765 patients, 46.0%, 40.4%, and 29.2% had undergone lung function, blood eosinophil count, and specific immunoglobulin E/radioallergosorbent testing, and 17.2%, 24.1%, and 58.7% were managed at GINA Steps 1-2, 3, and 4-5, respectively. Asthma was not well controlled in 57.3% of patients based on definitions adapted from the ERS/ATS and 10.7% of patients had experienced ≥1 severe exacerbation in the preceding year. According to patient self-reporting (n=603), the mean (SD) was 0.9 (0.1) for utility on EQ-5D-3L and was 7.8% (10.4%), 36.9% (20.0%), 40.8% (22.2%), and 37.9% (22.3%) for absenteeism, presenteeism, work productivity loss, and activity impairment, respectively, on WPAI. Both asthma control and humanistic burden worsened with progressive GINA treatment steps.
In patients seeking hospital-based asthma care in China, lung function and biomarker tests were underutilized, impairment in productivity and quality of life was observed, and more than half did not achieve well-controlled asthma despite approximately 60% being managed at GINA treatment Steps 4-5. These findings highlight the urgent need for optimizing asthma management in China.
为了优化中国的哮喘管理，本研究旨在通过分析在中国开展的阿德尔菲哮喘疾病特定项目的数据，全面调查寻求医院哮喘治疗的成年患者的临床特征、治疗模式、哮喘控制状况、急性加重情况及人文负担。
所有信息于调查日期（2018年8月至12月）从病历、医生或患者处收集，未进行随访。结果针对总体人群以及根据2018年全球哮喘防治创议（GINA）治疗步骤定义的亚组进行描述性总结。
纳入的765例患者中，分别有46.0%、40.4%和29.2%进行了肺功能、血嗜酸性粒细胞计数及特异性免疫球蛋白E/放射性变应原吸附试验，分别有17.2%、24.1%和58.7%的患者按照GINA第1 - 2步、第3步和第4 - 5步进行管理。根据欧洲呼吸学会/美国胸科学会（ERS/ATS）的定义，57.3%的患者哮喘控制不佳，10.7%的患者在前一年经历过≥1次严重急性加重。根据患者自我报告（n = 603），EQ - 5D - 3L效用均值（标准差）为0.9（0.1），工作效率和活动障碍问卷（WPAI）中旷工、出勤但工作效率低下、工作效率损失及活动受限的比例分别为7.8%（10.4%）、36.9%（20.0%）、40.8%（22.2%）和37.9%（22.3%）。随着GINA治疗步骤的推进，哮喘控制和人文负担均恶化。
在中国寻求医院哮喘治疗的患者中，肺功能和生物标志物检测未得到充分利用，观察到生产力和生活质量受损，尽管约60%的患者按照GINA治疗第4 - 5步进行管理，但仍有超过一半的患者哮喘未得到良好控制。这些发现凸显了中国优化哮喘管理的迫切需求。
