Lack of asthma and rhinitis control in general practitioner-managed patients prescribed fixed-dose combination therapy in Australia

Figures & data

Table 1. Patient demographics and clinical characteristics.

	Patients (N = 200)
Female, n (%)	128 (64.0)
Age in years, mean (SD)	47.7 (15.8)
Age range, years, n (%)
18–29	31 (15.5)
30–49	66 (33.0)
50 or more	103 (51.5)
Years since asthma diagnosis, n (%)
0–5	14 (7.0)
6–10	21 (10.5)
11 or more	165 (82.5)
BMI category, n (%)
Underweight (BMI < 18.49)	2 (1.0)
Normal (BMI 18.5–24.99)	63 (31.5)
Overweight (BMI 25–29.99)	66 (33.0)
Obese (BMI ≥ 30)	69 (34.5)
Highest level of education category, n (%)
Year 10 or below	94 (47.0)
Year 11–12	43 (21.5)
Certificate or diploma	30 (15.0)
University degree	33 (16.5)
Smoking history, n (%)
Never smoked	117 (59.0)
Past smoker	55 (27.0)
Current smoker	28 (14.0)
Comorbidities,^a n (%)
Rhinitis	98 (49.0)
Eczema	40 (20.0)
Gastro-oesophageal reflux disease	75 (37.5)
Hypertension	54 (27.0)
Diabetes	25 (12.5)
Cardiac disease	18 (9.0)
Fixed-dose combination treatment type, n (%)
Budesonide/eformoterol Turbuhaler	80 (40.0)
Fluticasone/salmeterol Metered Dose Inhaler	73 (36.5)
Fluticasone/salmeterol Accuhaler	47 (23.5)

Notes. Figures represent number (%) of patients or mean (SD).

^a Self-reported by patients as having been diagnosed by a doctor, in response to the question: ‘Do you have a diagnosis of any of the following conditions?’

Table 2. Indicators of asthma symptoms and exacerbations overall and by GINA-defined control levels.

		GINA-defined asthma control
	Overall (N = 200)	Controlled (n = 23)	Partially controlled (n = 77)	Uncontrolled (n = 100)	p Value^c
Control and indicators of symptoms
Days with symptoms^a
None	38 (19.0)	14 (60.9)	24 (31.2)	0	<0.001
1–2 days	55 (27.5)	9 (39.1)	38 (49.4)	8 (8.0)
≥3 days	107 (53.5)	0	15 (19.5)	92 (92.0)
Normal activities affected by symptoms^a
None	95 (47.5)	23 (100)	61 (79.2)	11 (11.0)	<0.001
≥1 day	105 (52.5)	0	16 (20.8)	89 (89.0)
Nighttime awakening^a
None	114 (57.0)	23 (100)	60 (77.9)	31 (31.0)	<0.001
≥1 day	86 (43.0)	0	17 (22.1)	69 (69.0)
Reliever inhaler use^a
None	69 (34.5)	16 (69.6)	39 (50.6)	14 (14.0)	<0.001
1–2 days	25 (12.5)	7 (30.4)	13 (16.9)	5 (5.0)
≥3 days	106 (53.0)	0	25 (32.5)	81 (81.0)
Acute exacerbations
Oral steroid use for worsening asthma^b
	147 (73.5)	20 (87.0)	67 (87.0)	60 (60.0)	<0.001
≥1 course	53 (26.5)	3 (13.0)	10 (13.0)	40 (40.0)
Days off work/education due to asthma^b
None	146 (73.0)	19 (82.6)	67 (87.0)	60 (60.0)	<0.001
≥1 day	54 (27.0)	4 (17.4)	10 (13.0)	40 (40.0)
Emergency department visit due to asthma^b
None	177 (88.5)	21 (91.3)	71 (92.2)	85 (85.0)	0.298
≥1 visit	23 (11.5)	2 (8.7)	6 (7.8)	15 (15.0)
Hospitalisation due to asthma^b
None	188 (94.0)	21 (91.3)	77 (100.0)	90 (90.0)	0.018
≥1 stay	12 (6.0)	2 (8.7)	0	10 (10.0)

Notes. Data are shown as n (%) of patients.

GINA; Global Initiative for Asthma.

^a In the previous 7 days.

^b In the previous 12 months.

^c p value from Chi-Square test.

Table 3. Perception of asthma control for the overall population and by GINA-defined control levels and history of exacerbations.

		GINA-defined asthma control			Acute exacerbations^a
	Overall (N = 200)	Controlled (n = 23)	Partially controlled (n = 77)	Uncontrolled (n = 100)	Oral steroid (n = 53)	Emergency department visits (n = 23)	Hospitalisations (n = 12)
Perception of asthma control
Not well controlled	67 (33.5)	2 (8.7)	14 (18.2)	51 (51.0)	27 (50.9)	14 (60.9)	8 (66.7)
Well controlled	133 (66.5)	21 (91.3)	63 (81.8)	49 (49.0)	26 (49.1)	9 (39.1)	4 (33.3)

Notes. Data are shown as n (%) of patients.

GINA; Global Initiative for Asthma.

^aAt least one in the previous 12 months due to asthma.

Figure 1. Incidence of rhinitis symptoms overall and by GINA-defined control levels. GINA; Global Initiative for Asthma. Self-reported rhinitis symptoms by patients, in response to the question: ‘Do you have any of these symptoms: itchy, runny, blocked nose or sneezing when you don't have a cold?’ with responses ranging from, 0 (no), 1 (occasionally and little bother), 2 (occasionally but quite a bother), 3 (most days but little bother), or 4 (most days and a lot of bother). Responses 1 and 3 were classified under ‘mild’ rhinitis symptoms and responses 2 and 4 under ‘moderate–severe’ rhinitis symptoms. Patients classified as having mild symptoms: n = 76; moderate–severe symptoms: n = 104; Global Initiative for Asthma-defined controlled: n = 23; partially controlled: n = 77; uncontrolled: n = 100).

Figure 2. Patterns of preventer medication use overall and by GINA-defined control levels. GINA; Global Initiative for Asthma. Self-reported pattern of preventer medication use by patients, in response to the question: ‘Which statement best describes how you take your regular asthma treatment?’ with the above five options. Patients taking a preventer inhaler (overall; N = 200; Global Initiative for Asthma-defined controlled: n = 23; partially controlled: n = 77; uncontrolled: n = 100).

Figure 3. Number of side effects experienced from preventer inhaler use overall and by GINA-defined control levels. GINA; Global Initiative for Asthma. Side effects experienced by patients from preventer inhaler use, in response to the question: ‘Do you experience any of these side effects from your preventer inhaler?’ with ‘yes’ or ‘no’ responses for the following side effects: continual sore mouth/throat; oral thrush; bruising; hoarse voice; abnormal weight gain and cough. Patients could indicate more than one side effect. Patients using a preventer inhaler (overall; N = 200; Global Initiative for Asthma-defined controlled: n = 23; partially controlled: n = 77; uncontrolled: n = 100).

Figure 4. Incidences of side effects from preventer inhaler use overall and by GINA-defined control levels. GINA; Global Initiative for Asthma. Self-reported side effects of preventer inhaler use by patients, in response to the question: ‘Do you experience any of these side effects from your preventer inhaler?’ with ‘yes’ or ‘no’ responses for the following side effects: continual sore mouth/throat; oral thrush; bruising; hoarse voice; abnormal weight gain and cough. Patients could indicate more than one side effect. Patients using a preventer inhaler (overall; N = 200; Global Initiative for Asthma-defined controlled: n = 23; partially controlled: n = 77; uncontrolled: n = 100).