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Adherence to Asthma Management Guidelines by Middle Aged Adults with Current Asthma
  1. Rangi K Kandane-Rathnayake (r.kandane{at}pgrad.unimelb.edu.au)
  1. MEGA Epidemiology Centre, The University of Melbourne, Australia
    1. Melanie C Matheson (mcmat{at}unimelb.edu.au)
    1. MEGA Epidemiology Centre, The University of Melbourne, Australia
      1. Julie A Simpson (julieas{at}unimelb.edu.au)
      1. MEGA Epidemiology Centre, The University of Melbourne, Australia
        1. Mimi L K Tang (mimi.tang{at}rch.org.au)
        1. Dept Allergy & Immunology, Murdoch Children’s Research Institute, Royal Children’s Hospi, Australia
          1. David P Johns (david.johns{at}utas.edu.au)
          1. Menzies Research Institute, Tasmania, Australia
            1. Desiree Mesaros (desiree.mesaros{at}utas.edu.au)
            1. Menzies Research Institute, Tasmania, Australia
              1. Richard Wood-Baker (richard.woodbaker{at}utas.edu.au)
              1. Menzies Research Institute, Tasmania, Australia
                1. Iain Feather (ifeather{at}bigpond.net.au)
                1. Gold Coast Hospital, Queensland, Australia
                  1. Stephen Morrison (stephen.morrison{at}uq.edu.au)
                  1. University of Queensland, Queensland, Australia
                    1. Mark A Jenkins (m.jenkins{at}unimelb.edu.au)
                    1. MEGA Epidemiology Centre, The University of Melbourne, Australia
                      1. Graham Giles (graham.giles{at}cancervic.org.au)
                      1. Cancer Epidemiology Centre, The Cancer Council of Victoria, Melbourne, Australia
                        1. John Hopper (j.hopper{at}unimelb.edu.au)
                        1. MEGA Epidemiology Centre, The University of Melbourne, Australia
                          1. Michael J Abramson (michael.abramson{at}med.monash.edu.au)
                          1. Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
                            1. Shyamali C Dharmage (shyamali{at}unimelb.edu.au)
                            1. MEGA Epidemiology Centre, The University of Melbourne, Australia
                              1. E Haydn Walters (haydn.walters{at}utas.edu.au)
                              1. Menzies Research Institute, Tasmania, Australia

                                Abstract

                                Background: With the increasing burden of asthma world-wide, much effort has been given to developing and updating management guidelines. Using data from the Tasmanian Longitudinal Health Study (TAHS), we investigated the adequacy of asthma management for middle aged adult asthmatics.

                                Methods: Information about spirometry, medication history and current asthma status was collected by the most recent TAHS when participants were in their mid-forties. Only those who reported ever having asthma were eligible for analysis of this manuscript.

                                Results: Of the 702 participants who reported ever having asthma, 50% had current asthma (n=351) of whom 71% were categorized 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. Our 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 development of fixed airflow obstruction.

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