Epidemiology of asthma in Australia   Guy Marks

Epidemiology of asthma in Australia Guy Marks PowerPoint PPT Presentation


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How many Australians have asthma?. 10.0%Approx. 2 million. Data source: 2007

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Epidemiology of asthma in Australia Guy Marks

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1. Epidemiology of asthma in Australia Guy Marks

3. Prevalence of current asthma by age and sex

5. Toelle et al. Br Med J 2004; 328:386-87 Primary School Children, Belmont, NSW: 1982, 1992, 2002

6. Control of asthma in general population sample

7. Relation between symptom frequency and self-assessed ‘control’

8. Mortality due to asthma Mortality due to asthma is uncommon 373 deaths attributed to asthma as the underlying cause in 2008 0.26% of all deaths in that year

9. Time trends in asthma mortality by sex 3 year moving average

10. Age distribution of asthma and all-cause mortality

11. Time trends in general practice encounters for asthma

12. Time trends in hospitalisations for asthma

13. Age distribution for hospitalisations for asthma and all causes

15. Hospitalisations for asthma by Indigenous status

16. Use of inhaled corticosteroids among adults, by potency class, age and number of prescriptions Figure 6.11: Use of inhaled corticosteroids among adults, by potency class, age and number of prescriptions, 2006 Notes (1) Least potent includes Becotide 100, Becotide MDI 100, Qvar 50, Qvar 50 autohaler, Pulmicort meter aero 100, Pulmicort turbuhaler, Alvesco 80, Flixotide jnr accuhaler, Flixotide jnr Oral pressurised inhalation 50 micrograms per dose (120 doses) CFC-free formulation, Seretide accuhaler 100/50, Seretide MDI 50/25, Symbicort turbuhaler 100/6. (2) Intermediate level includes Respocort inhaler Becloforte MDI 250, Respocort autohaler 250, Qvar 100, Qvar 100 autohaler, Pulmicort respules, Pulmicort meter aero 200, Pulmicort turbuhaler, Alvesco 160, Flixotide accuhaler, Flixotide, Seretide accuhaler 250/50, Seretide MDI 125/25, Symbicort turbuhaler 200/6. (3) Most potent includes Pulmicort respules, Pulmicort turbuhaler, Flixotide accuhaler, Flixotide, Seretide accuhaler 500/50, Seretide MDI 250/25, Symbicort turbuhaler 400/12. (4) Adults have been classified according to the most potent formulation of inhaled corticosteroid prescription they received in 2006. Sources: Pharmaceutical Benefits Scheme; Australian Bureau of Statistics.Figure 6.11: Use of inhaled corticosteroids among adults, by potency class, age and number of prescriptions, 2006 Notes (1) Least potent includes Becotide 100, Becotide MDI 100, Qvar 50, Qvar 50 autohaler, Pulmicort meter aero 100, Pulmicort turbuhaler, Alvesco 80, Flixotide jnr accuhaler, Flixotide jnr Oral pressurised inhalation 50 micrograms per dose (120 doses) CFC-free formulation, Seretide accuhaler 100/50, Seretide MDI 50/25, Symbicort turbuhaler 100/6. (2) Intermediate level includes Respocort inhaler Becloforte MDI 250, Respocort autohaler 250, Qvar 100, Qvar 100 autohaler, Pulmicort respules, Pulmicort meter aero 200, Pulmicort turbuhaler, Alvesco 160, Flixotide accuhaler, Flixotide, Seretide accuhaler 250/50, Seretide MDI 125/25, Symbicort turbuhaler 200/6. (3) Most potent includes Pulmicort respules, Pulmicort turbuhaler, Flixotide accuhaler, Flixotide, Seretide accuhaler 500/50, Seretide MDI 250/25, Symbicort turbuhaler 400/12. (4) Adults have been classified according to the most potent formulation of inhaled corticosteroid prescription they received in 2006. Sources: Pharmaceutical Benefits Scheme; Australian Bureau of Statistics.

17. Use of inhaled corticosteroids among children, by potency class, age and number of prescriptions Figure 6.12: Use of inhaled corticosteroids among children, by potency class, age and number of prescriptions, 2006 Notes (1) Least potent includes Becotide 100, Becotide MDI 100, Qvar 50, Qvar 50 autohaler, Pulmicort meter aero 100, Pulmicort turbuhaler, Alvesco 80, Flixotide jnr accuhaler, Flixotide jnr Oral pressurised inhalation 50 micrograms per dose (120 doses) CFC-free formulation, Seretide accuhaler 100/50, Seretide MDI 50/25, Symbicort turbuhaler 100/6. (2) Intermediate level includes Respocort inhaler Becloforte MDI 250, Respocort autohaler 250, Qvar 100, Qvar 100 autohaler, Pulmicort respules, Pulmicort meter aero 200, Pulmicort turbuhaler, Alvesco 160, Flixotide accuhaler, Flixotide, Seretide accuhaler 250/50, Seretide MDI 125/25, Symbicort turbuhaler 200/6. (3) Most potent includes Pulmicort respules, Pulmicort turbuhaler, Flixotide accuhaler, Flixotide, Seretide accuhaler 500/50, Seretide MDI 250/25, Symbicort turbuhaler 400/12. (4) Children have been classified according to the most potent formulation of inhaled corticosteroid prescription they received in 2006. Sources: Pharmaceutical Benefits Scheme; Australian Bureau of Statistics. Figure 6.12: Use of inhaled corticosteroids among children, by potency class, age and number of prescriptions, 2006 Notes (1) Least potent includes Becotide 100, Becotide MDI 100, Qvar 50, Qvar 50 autohaler, Pulmicort meter aero 100, Pulmicort turbuhaler, Alvesco 80, Flixotide jnr accuhaler, Flixotide jnr Oral pressurised inhalation 50 micrograms per dose (120 doses) CFC-free formulation, Seretide accuhaler 100/50, Seretide MDI 50/25, Symbicort turbuhaler 100/6. (2) Intermediate level includes Respocort inhaler Becloforte MDI 250, Respocort autohaler 250, Qvar 100, Qvar 100 autohaler, Pulmicort respules, Pulmicort meter aero 200, Pulmicort turbuhaler, Alvesco 160, Flixotide accuhaler, Flixotide, Seretide accuhaler 250/50, Seretide MDI 125/25, Symbicort turbuhaler 200/6. (3) Most potent includes Pulmicort respules, Pulmicort turbuhaler, Flixotide accuhaler, Flixotide, Seretide accuhaler 500/50, Seretide MDI 250/25, Symbicort turbuhaler 400/12. (4) Children have been classified according to the most potent formulation of inhaled corticosteroid prescription they received in 2006. Sources: Pharmaceutical Benefits Scheme; Australian Bureau of Statistics.

18. Medication use by type of asthma

21. Effect of cost on use of inhaled corticosteroids in 2006 (PBS)

22. Use of asthma medication in the last 2 weeks among people with asthma (NHS)

23. 1 in 10 have current self-reported asthma Age gradient is diminishing Sex distribution differs between adults and children Most have “adequate” control Mortality and hospitalisation rates have fallen substantially in 1990s but recently stabilised (esp. hospitalisation) Significant and important socio-demographic gradients

24. ICS and ICS/LABA use does not fit with expectations Cost is a major barrier to regular use Possible use of ICS/LABA combination for other respiratory syndromes (not asthma or COPD) Possible intermittent use in people with asthma

25. Can asthma be considered in isolation from other forms of obstructive lung disease? Can we consider novel strategies for making regular ICS affordable among those who stand to gain most from regular use?

26. Acknowledgments Leanne Poulos Rosario Ampon Anne-Marie Waters Wei Xuan Elena Belousova The Australian System for Monitoring Asthma Steering Committee

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