Adherence to asthma management guidelines by middle-aged adults with current asthma
- R K Kandane-Rathnayake1,
- M C Matheson1,
- J A Simpson1,2,
- M L K Tang3,4,
- D P Johns5,
- D Mészáros5,
- R Wood-Baker5,
- I Feather6,
- S Morrison7,
- M A Jenkins1,
- G G Giles1,2,
- J Hopper1,
- M J Abramson8,
- S C Dharmage1,
- E H Walters1,5,8
- 1Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
- 2Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
- 3Department of Allergy and Immunology, Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
- 4Department of Paediatrics, University of Melbourne, Melbourne, Australia
- 5Menzies Research Institute, Tasmania, Australia
- 6Gold Coast Hospital, Queensland, Australia
- 7University of Queensland, Queensland, Australia
- 8Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Correspondence to Ms R Kandane-Rathnayake, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Department of Public Health, School of Population Health, The University of Melbourne, Level 1/723 Swanston Street, Carlton, Victoria 3053, Australia; r.kandane{at}pgrad.unimelb.edu.au
- Received 23 April 2009
- Accepted 17 July 2009
- Published Online First 23 August 2009
Abstract
Background: With the increasing burden of asthma worldwide, much effort has been given to developing and updating management guidelines. Using data from the Tasmanian Longitudinal Health Study (TAHS), the adequacy of asthma management for middle-aged adults with asthma was investigated.
Methods: Information about spirometry, medication history and current asthma status was collected by the most recent TAHS when participants were in their mid 40s. Only those who reported ever having asthma were eligible for analysis.
Results: Of the 702 participants who reported ever having asthma, 50% had current asthma (n = 351) of whom 71% were categorised as having persistent asthma (n = 98 mild, n = 92 moderate, n = 58 severe). The majority (85.2%) of participants with current asthma had used some form of asthma medication in the past 12 months, but the proportion of the use of minimally adequate preventer medication was low (26%). Post-bronchodilator airflow obstruction increased progressively from mild to severe persistent asthma for those inadequately managed, but not for those on adequate therapy.
Conclusion: Appropriate use of asthma medication by this middle-aged group of adults with current asthma was inadequate, especially for those with adult-onset moderate or severe persistent disease and without a family history of asthma. These results suggest that proper use of preventer medication could protect against the progressive decline in lung function associated with increasing severity. This has implications not just for poor quality of life, but also for the development of fixed airflow obstruction.
Footnotes
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Funding This study was funded by the National Health and Medical Research Council of Australia, Clifford Craig Medical Research Trust of Tasmania and Victorian & Tasmanian Asthma Foundations. RKK-R, MCM, SCD and JH are supported by the National Health and Medical Research Council.
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Competing interests None.
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Provenance and peer review Not commissioned; externally peer reviewed.
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Ethics approval The 2004 follow-up studies were approved by the Human Research Ethics Committee at the Universities of Melbourne, Tasmania and Monash, and Royal Brisbane Hospital.
