Dubai Final-v20.indd - World Allergy Organization

ABstrACts
ABstrACts
1210
imPlEmEnTaTion oF gUiDElinES in rEal-WorlD UK aSTHma managEmEnT
ryan, D. 1 , Haughney, J. 2 , thomas, m. 2 , Pinnock, H. 3 , Price, D. 2 , Ellis, s. 4 and Chisholm, A. 4
1 2 Woodbrook medical Centre, loughborough, United Kingdom. Centre of Academic Primary Care, University of Aberdeen, Aberdeen,
United Kingdom. 3Allergy and respiratory research group, Centre for Population Health sciences: gP section, the University of
Edinburgh, Edinburgh, United Kingdom. 4research in real life, Cawston, United Kingdom.
Background: Current asthma guidelines suggest use of add-on therapy (i.e. leukotriene receptor antagonists (ltrAs), theophylline
(theo), oral beta -agonists) in patients whose asthma control remains inadequate despite daily high-dose inhaled corticosteroid
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(hdiCs) and long-acting beta -agonist (lABA) therapy.
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objectives: to evaluate the proportion of patients on daily hdiCs/lABA therapy experiencing exacerbations (1, 2 and ≥3
exacerbations annually), but who have not received a trial of additional add-on therapy.
methods: retrospective study using the general Practice research Database (gPrD) to identify inadequately controlled hdiCs/lABA
patients (average iCs daily dose of ≥800mcg beclometasone dipropionate equivalent in the prior year and ≥1 lABA prescription
in the prior 2 years) and the proportion prescribed appropriate “additional add-on therapy” (namely ≥1 month of: ltrA, or theo, or
oral beta -agonists ever). We used a history of exacerbations (1, 2, ≥3 exacerbations) as evidence of poor control. High risk patients
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were those with ≥2 exacerbations in the prior year, detected using a composite measure based on the American thoracic society /
European respiratory society exacerbation definition, namely records of: acute oral steroid prescriptions, hospital admissions and
Accident & Emergency attendance for asthma.
results: Of 96,964 asthma patients in the dataset, 21,994 (23%) were prescribed hdiCs+lABA. Of these, 17,971 (82%) had
never received additional add-on therapy. Although patients experiencing exacerbations were more likely to have been prescribed
additional add-on therapy (p