Article Text


Therapeutic interventions in asthma and airways disease
P184 Can we predict asthma exacerbations in working-age adults?
  1. S J MacNeill1,
  2. A B Jones1,
  3. C J P Smith2,
  4. R Hubbard2,
  5. P Cullinan1
  1. 1National Heart and Lung Institute (Imperial College), London, UK
  2. 2Division of Epidemiology and Public Health (University of Nottingham), Nottingham, UK


Introduction Little information exists on the prevalence and risk factors of asthma exacerbations in the general population. We used GP records to determine whether we can predict exacerbations in adults from their medical history.

Methods Using the Health Improvement Network database, weidentified all patients aged 16–40 years with “current asthma” (≥1 asthma prescription between 01/07/98 and 01/07/00). Three types of asthma exacerbations were studied: “hospital” defined as events resulting in attendance at A&E or admission; “GP” defined as events occurring during out-of-hours consultations; and “prednisolone” defined as non-repeat prescriptions of oral prednisolone for asthma.

Results 73 462 patients were identified. They were on average 28 years old and 56% were female. 36,762 (50%) were registered for at least 5 years pre-qualification and 1 year post. Of these, 0.3% had at least one hospital exacerbation in the first year post, 2.4% had at least one GP exacerbation and 8.3% had at least one prednisolone exacerbation. Women and those prescribed a reliever and preventor at qualification were more likely to have exacerbations (see Abstract P184 Table 1). The prevalence of exacerbations was associated with an increasing number and increasingly recent history of exacerbations pre-qualification.

Abstract P184 Table 1

Prevalences of at least one exacerbation in the first year post-qualification

Discussion These results show that while few have hospital exacerbations, GP and prednisolone exacerbations are comparatively common. For all types, a previous and recent history of exacerbations increases the risk of future exacerbations.

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