The burden of mild asthma: Clinical burden and healthcare resource utilisation in the NOVELTY study
Sarowar Golam, Christer Janson, Richard Beasley, J. Mark FitzGerald, Tim Harrison, Bradley E. Chipps, Rod Hughes, Hana Müllerová, José María Olaguibel, Eleni Rapsomaniki, Helen K. Reddel, Mohsen Sadatsafavi, Gabriel Benhabib, Piush J. Mandhane, Xavier Bocca Ruiz, Andrew McIvor, Ricardo del Olmo, Bonavuth Pek, Raúl Lisanti, Robert Petrella, Gustavo Marino, Daniel Stollery, Walter Mattarucco, Meihua Chen, Juan Nogueira, Yan Chen, Maria Parody, Wei Gu, Pablo Pascale, Kim Ming Christopher Hui, Pablo Rodriguez, Manxiang Li, Damian Silva, Shiyue Li, Graciela Svetliza, Li-Jun Ma, Carlos Victorio, Guangyue Qin, Roxana Willigs Rolon, Weidong Song, Anahí Yáñez, Wei Tan, Stuart Baines, Yijun Tang, Simon Bowler, Chen Wang, Peter Bremner, Tan Wang, Sheetal Bull, Fuqiang Wen, Patrick Carroll, Feng Wu, Mariam Chaalan, PingChao Xiang, Claude S. Farah, Zuke Xiao, Gary Hammerschlag, Shengdao Xiong, Kerry Hancock, Jinghua Yang, Zinta Harrington, Jingping Yang, Gregory Katsoulotos, Wei Zhang, Joshua Kim, Min Zhang, David Langton, Ping Zhang, Donald Lee, Wei Zhang, Matthew Peters, Xiaohe Zheng, Lakshman Prassad, Dan Zhu, Helen K. Reddel, Fabio Bolívar Grimaldos, Dimitar Sajkov, Alejandra Cañas Arboleda, Francis Santiago, Carlos Matiz Bueno, Frederick Graham Simpson, Dora Molina de Salazar, Sze Tai, Elisabeth Bendstrup, Paul S. Thomas, Ole Hilberg, Peter Wark, Carsten Kjellerup, José Eduardo Delfini Cançado, Ulla Møller Weinreich, Thúlio Cunha, Philippe Bonniaud, Marina Andrade Lima, Olivier Brun, Alexandre Pinto Cardoso, Pierre‐Régis Burgel, Marcelo Fouad Rabahi, C. Chouaïd, Syed Anees, Françis Couturaud
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.