COPD, Asthma Admissions Increased Substantially in England, Wales 1999 to 2020

Hospital admissions and medication prescriptions associated with chronic obstructive pulmonary disease (COPD) and asthma increased substantially from 1999 to 2020, according to study findings published in BMC Pulmonary Medicine.

Researchers conducted a cross-sectional ecological study assessing trends in asthma- and COPD-related hospital admissions and medication prescriptions in England and Wales between 1999 and 2020.

Data were obtained from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales from April 1999 to April 2020. Data regarding COPD and asthma medication prescriptions in England and Wales were collected from the Prescription Cost Analysis database for 2004 to 2020.

The total annual number of COPD and asthma hospital admissions for various causes increased by 82.2% (from 210,525 in 1999 to 383,652 in 2020), which was an increased hospital admission rate of 59.1% (403.77; 95% CI, 402.05-405.49 in 1999 to 642.42; 95% CI, 640.39-644.45 in 2020 per 100,000 persons, trend test, P <.05).

COPD with acute lower respiratory infection was the most common COPD and asthma hospital admissions cause, which accounted for 38.7% of admissions.

Participants aged 75 years and older accounted for 34.7% of the total number of COPD and asthma hospital admissions, followed by those aged 60 to 74 years (33.0%). Conversely, hospital admission rates for COPD and asthma for patients younger than 15 years of age were reduced by 28.5% (from 278.84; 95% CI, 275.56-282.13 in 1999 to 199.34; 95% CI, 196.67-202.01 in 2020 per 100,000 persons).

During the study period, 6,068,837 COPD and asthma hospital admissions were reported in England and Wales. Female patients accounted for 53.8% of COPD and asthma hospital admissions.

The absolute number of COPD and asthma medication prescriptions that were dispensed annually increased by 42.2% (from 42,062,859 in 2004 to 59,819,658 in 2020). Bronchodilators and corticosteroids (respiratory) were the most common COPD and asthma medication prescriptions (59.1% and 37.3%, respectively).

The researchers noted that their findings are based on an ecological study on the population level, not individual level, which limited their ability to retrieve data for comorbidities, medication history and adherence, and laboratory history. In addition, the researchers were unable to estimate the age-adjusted rate of admissions, and systematic differences may exist across regions in tracking disease frequency and measuring exposures.

“Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups,” the study authors concluded. The notable exception to this was the finding that admissions among children under the age of 15 decreased during the study period.