Disease Control, Not Severity, Drives Job Absenteeism in Young Adults with Asthma – A Nationwide Cohort Study

Figures & data

Table 1 Demographics, Comorbidities, and Treatment of 60,534 Patients with Actively Treated Asthma and an Age- and Sex Matched Control Group

	Background Population (N = 60,534)^a	Any Asthma (N = 60,534)^a	Mild-to-Moderate Asthma (N = 57,059)^a	Possible Severe Asthma (N = 3475)^a
Age	33 (25, 39)	33 (25, 39)	33 (25, 39)	36 (29, 40)
Female	33,056 (54.6%)	33,056 (54.6%)	31,144 (54.6%)	1,912 (55.0%)
GINA 2020 Treatment Step
Step 1	N/A	25,497 (42.1%)	25,497 (44.7%)	0 (0%)
Step 2	N/A	13,092 (21.6%)	13,092 (22.9%)	0 (0%)
Step 3	N/A	13,411 (22.2%)	13,411 (23.5%)	0 (0%)
Step 4	N/A	6,005 (9.9%)	5,059 (8.9%)	946 (27.2%)
Step 5	N/A	2,529 (4.2%)	0 (0%)	2,529 (72.8%)
Bronchodilator Use
Long-acting Beta2-agonists	N/A	23,302 (38.5%)	19,997 (35.0%)	3,305 (95.1%)
Long-acting antimuscarinics	N/A	1,574 (2.6%)	1,061 (1.9%)	513 (14.8%)
Dual long-acting bronchodilators	N/A	1,574 (1.7%)	545 (1.0%)	486 (14%)
Annual SABA Use	N/A	195 (60, 280)	180 (60, 267)	220 (100, 565)
>600 annual SABA doses	N/A	5,762 (9.5%)	4,908 (8.6%)	854 (24.6%)
Uncontrolled Disease^b		11,531 (19.0%)	9,627 (16.9%)	1,904 (54.8%)
Charlson Index ≥2	250 (0.4%)	468 (0.8%)	411 (0.7%)	57 (1.6%)

Notes: ^aStatistics presented: n (%); median (IQR). ^bBased on >600 annual SABA doses, 2+ moderate or 1+ severe exacerbation(s).

Abbreviations: GINA, Global Initiative for Asthma; SABA, short-acting bronchodilator.

Figure 1 Prevalence of job absenteeism in 60,534 patients with actively treated asthma stratified by asthma severity and presented as (A) absolute prevalences and (B) relative absenteeism. N.B.: Individual patients can claim more than one kind of absenteeism benefits during the observation period.

Table 2 Job Absenteeism During 15 Years of 60,534 Patients with Actively Treated Asthma and an Age- and Sex Matched Control Group

Job Absenteeism	Any Job Absenteeism		Temporary Sick Leave		Unemployment		Disability
	Total weeks	95% CI	Total weeks	95% CI	Total weeks	95% CI	Total weeks	95% CI
Background Population	7.73	7.49–7.86	1.45	1.42–1.49	4.39	4.29–4.49	1.93	1.93–1.94
Mild-to-Moderate Asthma	10.12	9.94–10.30	1.99	1.95–2.04	5.02	4.91–5.14	3.26	3.25–3.26
Possible Severe Asthma	15.90	14.78–17.10	2.84	2.58–3.12	6.04	5.51–6.63	7.22	7.19–7.25

Abbreviation: CI, confidence interval.

Figure 2 Relative incidence of job absenteeism in 60,534 patients with actively treated asthma stratified by (A) disease severity in comparison to a 1:1 age- and sex-matched background population, (B) asthma control (uncontrolled defined as either ≥600 annual doses of rescue medication, ≥2 prescriptions of oral corticosteroids or ≥1 asthma-related hospitalization) or (C) GINA 2020 Treatment Step during the study inclusion period. All models adjusted for age, sex, Charlson score and education level.

Figure 3 Relative incidence of overall job absenteeism in 60,534 patients aged 18–45 with actively treated asthma stratified by (A) annual rescue medication use, (B) number of oral corticosteroid prescriptions and (C) number of asthma-related hospitalizations during the study inclusion period. All models adjusted for age, sex, Charlson score and education level.