A population-based United Kingdom study found that lower disease control and higher rates of asthma exacerbation were linked to poorer areas. Older patients and people of color were particularly hard hit, according to findings published in the Journal of Asthma and Allergy.
The study analyzed a cohort of 127,040 patients with asthma from the Optimum Patient Care Research Database, a nationally representative UK dataset. Researchers assessed the demographics, clinical variables, and healthcare utilization of patients with asthma, making comparisons of patients from differing socio-economic status (SES) quintiles as defined by the UK 2011 Indices of Multiple Deprivation (with socioeconomic status taking into account education, housing, living environment, and more). Participants included 28,215 individuals in the least-deprived quintiles and 16,534 individuals from the most deprived quintiles, with a mean patient age of 51.2 years.
In comparing the most deprived vs least deprived SES quintiles, investigators found the odds ratios (ORs) for uncontrolled disease and asthma exacerbation were 1.54 and 1.27, respectively. The most deprived quintile also harbored increased blood eosinophils and decreased peak flow. Participants aged 75 years and older as well as those from ethnic minority groups were the most negatively affected. The proportion of patients achieving good medication adherence to ICS was higher in the most-deprived group (OR, 1.43; 95% CI, 1.17-1.76), although asthma reviews and respiratory referrals did not appear to vary by SES. Likewise, results showed that patients in the most-deprived group did not experience any asthma disparities due to BMI or smoking.
Overall, concluded investigators, “We found worse disease control and increased exacerbation rates among patients with asthma from more deprived areas. There was evidence that the magnitude of socioeconomic disparities was elevated among older patients and those from ethnic minority groups. The drivers of these differences require further exploration.”
Disclosure: This research was supported by AstraZeneca, and some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Busby J, Price D, Al-Lehebi R, et al. Impact of socioeconomic status on adult patients with asthma: A population-based cohort study from UK primary care. J Asthma Allergy. Published online on November 10, 2021. doi:10.2147/jaa.s326213