Severe Asthma

A small qualitative study in NSW and VIC interviewed 32 adults with severe asthma, currently treated, and reported that timely severe asthma diagnosis in Australia appears to be hampered by an absence of a clear referral process, lack of general practitioner (GP) knowledge of additional treatment options, under-utilisation of pharmacists, and multiple specialists treating patient comorbidities.
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A Cross-sectional survey of 6048 adult Australians with current asthma in the community (conducted in Feb-March 2021 during Covid measures) found that:
– 21.7% had difficult-to-treat asthma (DTTA)
– 85.4% of the participants with DTTA had at least 1 other chronic condition (comorbidity)

Note: DTTA was defined as severe asthma and/or poor asthma control and/or urgent asthma healthcare in previous 12 months despite medium-high dose ICS/LABA.

According to a cross-sectional survey of 6048 adult Australians with current asthma in the community (conducted in Feb-March 2021 during Covid measures), 21.7% of adults with asthma had difficult-to-treat asthma (DTTA) in 2021, of which:
– 50.4% had very poorly controlled asthma
– 36.2% were current smokers
– 85.4% had at least 1 additional chronic condition
61.4% of those with DTTA had at least 1 urgent GP visit in the last 12 months (compared to 27.5% in non-DTTA people; 4.8 times more likely).
41.9% of those with DTTA had at least 1 ED visit in the last 12 months (compared to 17.9% in non-DTTA; 3.8 times more likely).

The prevalence of DTTA was higher is areas of greater socioeconomic disadvantage, where participants were also less likely to have received biologic therapy in the previous three months.

DTTA was defined as severe asthma and/or poor asthma control and/or urgent asthma healthcare in previous 12 months despite medium-high dose ICS/LABA.
Note: the survey was conducted during COVID measures which may have impacted healthcare utilisation.

article that summarises the use of biologics in severe asthma, and includes a table describing the 4 biologics used in Australia and their clinical requirements.

Approximately 3 – 10% of people with asthma have severe asthma.

Severe refractory and difficult-to-treat asthma is responsible for over 50% of asthma health care costs.