Use of OSC in Australia and regional variations, a heat map analysis (published 2022)

More than 1 in 5 people with asthma using high-dose ICS/LABA regularly (filling at least 2 prescriptions within 6 months) received a dose of OCS sufficient to cover 2 exacerbations or more within those 6 months.
A recent study analysing prescription medications dispensed by about 82% of community pharmacies in Australia reported that:
– 22% of patients with difficult to treat asthma (defined as filling at least 2 prescriptions of high-dose ICS/LABA in 6 months) received sufficient OCS to cover at least 2 exacerbations within 6 months
– 10% of patients with difficult to treat asthma (defined as filling at least 2 prescriptions of high-dose ICS/LABA) received 1000mg or more OCS within 6 months
– 13% of patients with difficult to treat asthma (defined as filling at least 4 prescriptions of high-dose ICS/LABA; stringent analysis) received 1000mg or more OCS within 6 months

Geographical areas: Heat maps SA3 areas
Refer to Table 1 and Figure 3, map A for proportion of difficult to treat asthma, map B for proportion of difficult to treat asthma receiving 2 OCS scripts or more within 6 months, and map C for proportion of OCS above 1000mg within 6 months.

Difficult to treat asthma (defined as at least 2 prescriptions for high-dose ICS/LABA in 6 months):
– SA3 regions with the highest proportions of difficult to treat asthma were located more frequently in WA (22/36) followed by NT (2/9), VIC (14/66), TAS (2/15) and NSW (9/95)
– region with highest proportion (48%) was in WA, followed by a region on NSW (43%)

Uncontrolled asthma among difficult to treat asthma (prescription of enough OCS within 6 months to treat 2 exacerbations):
– SA3 regions with the highest proportions of uncontrolled asthma were located more frequently in SA (7/28) followed by TAS (3/15), VIC (9/66), QLD (5/82) and NSW (5/95)
– region with highest proportion of uncontrolled asthma (67%) was in NSW

1000mg OCS or more within 6 months among difficult to treat asthma:
– in 29 SA3 regions, 13% to 34% of patients with difficult to treat asthma were prescribed 1000mg OCS or more within 6 months. Most of them located in the Eastern half of Australia
– highest rate (34%) was in a region in NSW
– lowest rate (3%) was in a region in NT

A. Proportions of difficult to treat asthma (2 or more high-dose ICS/LABA in 6 months)

B. Proportions of uncontrolled asthma (OCS prescription sufficient for 2 or more exacerbations in 6 months) among difficult to treat asthma
C. Proportions receiving 1000mg or more OCS within 6 months among difficult to treat asthma