Asthma control and associated characteristics in Dutch primary care patients assessed with the AsthmaOptimiser during regular consultations

05 May 2022
Clinical Research Results Abstract Introduction: Guidelines for asthma management focus on achieving asthma control and reducing exacerbation risk. However, more research into the prevalence of uncontrolled asthma (UA) and associated characteristics is required. This study aims to determine the proportion of primary care patients with UA, assessed during regular consultations using the digital AsthmaOptimiser tool1 which gives structured guidance during consultations and provides guideline-based management suggestions1,2 Additionally, we investigated whether UA was associated with 1) blood eosinophil counts or 2) Work Productivity and Activity Impairment (WPAI).Methods: We enrolled 220 adult asthma patients in Dutch primary care practices. Blood eosinophil counts (‘point-of-care’) and WPAI were measured. UA was defined as an ACQ-score ≥0.753. We employed generalized linear mixed models with asthma control as the dependent variable (logit, UA = 1), and a random intercept at the level of general practices. Results: Of the 220 patients, 132 (60%) had UA, of which 85 (64%) could be optimized in primary care, 45 (34%) were advised to be referred to secondary care, and two were already under specialist care (Table 1). Despite the advice for referral, only three patients were referred. Blood eosinophil count was not related to UA (OR = 0.4; 95% CI [0.07, 2.21]; p = 0.3). UA patients were at greater odds to be impaired at work (OR = 1.07 per % increase in impairment; 95% CI [1.04, 1.12]; p < 0.01) and in their daily activities (OR = 1.07 per %; 95% CI [1.05, 1.09]; p < 0.01) (Table 2).Discussion: 60% of patients in this study had UA. UA patients were more impaired in their daily life, but their level of asthma control was not associated with blood eosinophil counts. Primary care healthcare providers indicated to prefer a follow-up consultation before referring, indicating that barriers for referral exist. These should be further explored. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Supplemented due to length References and Clinical Trial Registry Information References: Wouters, H. Study Design for a qualitative assessment of the implementation of the Asthma Navigator (Refer ID) tool in a Dutch primary care setting. 2021. IPCRG conference Dublin 2021. Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (updated 2021), 2021. Last accessed January 2022, GINA report 2021Nederlands Huisartsen Genootschap, ‘Astma bij volwassenen, NHG-standaard M27’. Last accessed January 2022, Dutch guidelines asthma in adultsThis study was registered under Clinical trials gov ID: NCT04456270

Resource information

Respiratory conditions
  • Asthma
Type of resource
Malaga 2022
Bertine M.J. Flokstra-de Blok, GPRI