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Multicenter Study
. 2019 Jul 11;29(1):25.
doi: 10.1038/s41533-019-0137-7.

Real-life prescribing of asthmatic treatments in UK general practice over time using 2014 BTS/SIGN steps

Alicia Gayle  1 , Abigail Tebboth  2 , Marie Pang  2 , Florent Guelfucci  3 , Ramzi Argoubi  3 , Steven Sherman  4 , Vincent Mak  5
Affiliations
Multicenter Study

Real-life prescribing of asthmatic treatments in UK general practice over time using 2014 BTS/SIGN steps

Alicia Gayle et al. NPJ Prim Care Respir Med. .

Abstract

The 2014 British Thoracic Society (BTS) and Scottish Intercollegiate Guideline Network (SIGN) guidelines recommend a stepwise approach to asthma management. We investigated the management of asthma in primary care in the UK to understand how real-world practice compares with BTS/SIGN guidelines. Asthma patients were identified from the UK Clinical Practice Research Datalink from September 2006 to August 2016. Aims were to classify patients according to BTS/SIGN steps, describe the proportion of patients transitioning between steps and describe patient demographics and clinical characteristics per group. Overall, 647,308 patients with asthma were identified (40,096 aged 5-11 years; 607,212 aged 12-80 years). Most treated patients were in step 1 or 2 (88.3% of children/67.5% of adults in December 2007; 83.0% of children/67.0% of adults in June 2016). Most patients remained within their treatment step within a 6-month interval (>78% of children and adults throughout the study duration). The proportion of patients stepping up and down reduced from the beginning of the study, although stepping down to step 1 was relatively common in both adults and children. Few patients had a recorded asthma review in the year before reference date (18.8% of children and 14.8% of adults). Although prescribing patterns meant that most patients remained within their treatment step throughout the study, we cannot be sure that this was because their disease was truly stable. The small proportion of patients stepping up/down and the lack of recorded asthma review suggest that patients may not be treated in accordance with BTS/SIGN guidelines.

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Conflict of interest statement

A.G., M.P. and A.T. are employees of the study sponsor, Boehringer Ingelheim. V.M. has received honoraria for lectures and advisory boards from AstraZeneca, Pfizer, Chiesi, Teva and Boehringer Ingelheim and sponsorship to attend conferences from AstraZeneca, Chiesi, Teva and Boehringer Ingelheim.

Figures

Fig. 1
Fig. 1
Distribution of patients in treatment steps, at each 6-month time interval
Fig. 2
Fig. 2
Proportion of patients stepping up, down or remaining stable within a 6-month period (patients in steps 0 to 5)
Fig. 3
Fig. 3
Flow of paediatric patients between steps from one 6-month interval to the next
Fig. 4
Fig. 4
Flow of adult patients between steps from one 6-month interval to the next
See this image and copyright information in PMC

References

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