The presence of a chronic comorbidity, which is typical in patients with asthma, is more common in women with asthma than in men, with the odds of having a specific comorbid condition differing between the genders. A real-life, retrospective cohort study was conducted using a general practice database from the Department of Primary and Community Care at the Radbound University Medical Centre in Nijmegen, The Netherlands. Results of the analysis were published in NPJ Primary Care Respiratory Medicine.
Recognizing that the presence of a comorbidity can be associated with poor outcomes in adult patients with asthma, investigators sought to establish age-specific and gender-specific prevalence estimates of the full range of chronic comorbid conditions. They based their study on data from 32,787 medical records of patients ≥16 years of age with asthma from 179 general practices in The Netherlands. (Dutch general practitioner asthma treatment guidelines consider patients ≥16 years to be adults.) The prevalence estimates of 76 chronic comorbidities and 14 disease categories were determined based on International Classification of Primary Care codes.
The results revealed that a chronic comorbidity was present in 65.3% of male patients with asthma compared with 72.8% of female patients with asthma. In fact, the female patients had a higher mean number of comorbidities than the male patients (2.0±2.1 comorbidities vs 1.7±2.0 comorbidities, respectively). The mean number of comorbidities increased in patients ≥75 years of age (5.02±2.66 in men vs 5.01±2.65 in women).
The most prevalent comorbidities reported were hypertension (20.1%), eczema (11.5%), osteoarthritis (11.5%), dyspepsia (10.7%), and chronic obstructive pulmonary disease (9.5%). Compared with male patients with asthma, female patients with asthma exhibited a statistically significantly higher likelihood of the presence of other chronic disorders in 8 disease categories. Neurologic (odds ratio [OR], 2.01; 95% CI, 1.76-2.29), blood-forming/lymphatics (OR, 1.83; 95% CI, 1.38-2.42), and musculoskeletal diseases (OR, 1.82; 95% CI, 1.69-1.95) had the highest association with the female gender.
The investigators concluded that guidelines need to focus attention on how to handle comorbid conditions in patients with asthma to potentially lead to a more targeted treatment of these disorders and more patient-centered management of asthma.
Veenendaal M, Westerik JAM, van den Bemt L, Kocks JWH, Bischoff EW, Schermer TR. Age- and sex-specific prevalence of chronic comorbidity in adult patients with asthma: a real-life study.NPJ Prim Care Respir Med. 2019;29(1):14.