Asthma treatment varies dramatically worldwide, and this study provides individual-level reporting on medication use and disease severity across various economic categories.
Among non-communicable diseases, asthma is one of the most commonly occurring globally, affecting more than 350 million people. Although most asthma patients are able to receive asthma control, this is not attained in many cases. This can be due to poor adherence to management protocols, doctors not following guidelines, some treatment options being unavailable or unaffordable, or some combination of these factors.
The Global Asthma Network (GAN) recently conducted a Phase 1 cross-sectional study that provided data on the burden that asthma places on children, adults, and adolescents, along with trends in the development of these burdens over time. This study, published in The Lancet Global Health, uses GAN Phase 1 data to understand the way that asthma is treated, managed, and diagnosed throughout the world.
Gathering Data on Asthma Severity and Medication Use Worldwide
The data from this study includes questionnaires that were given to children in different age categories as well as adults. If an individual participant had an asthma diagnosis by a doctor, this was collated with responses on past-year asthma medications used, including the type of medicine and frequency of use. Information on the number and type of health visits was also gathered. Countries were placed into different income-based categories based on both gross national income per capita and their World Bank classification. The authors used generalized structural equation multilevel models to analyze factors associated with both receiving medicines and having poorly controlled asthma in each age group.
Medication Types and Usage Rates: Looking at an Age-Based Distribution
The study relied on data from 453,473 individuals, which was gathered from 63 centers in 25 countries. Asthma was found in 6.3% of children, 7.9% of adolescents, and 3.4% of adults overall. All age groups included a high proportion (44.8% for children, 60.1% for adolescents, and 55.5% for adults) of patients with severe asthma symptoms who did not take inhaled corticosteroids. This proportion was significantly higher in middle- and low-income countries. Some kind of asthma management plan was used by a large percentage of patients in most categories, but this was markedly higher in children. Overall, poor control of asthma symptoms was associated with low country income.
This study found that asthma medication use increases as severity increases, and that oral short-acting β2 agonists use is very common, despite low efficacy and increased adverse effects. Lower-income countries tended to have a larger proportion of patients with severe asthma who did not use any type of medication, pointing to a global disparity in the use of asthma medication. These countries also had lower rates of asthma plan use. These findings can be used to better understand the current use and distribution of asthma medications, with the aim of improving rates of effective medication use.
Garcia-Marcos, L., Chiang, C., Asher, I., Marks, G. B., Sony, A. E., Masekela, R., Bissell, K., Ellwood, E., Ellwood, P., Pearce, N., Strachan, D. P., Mortimer, K., Morales, E., Ahmetaj, L. N., Ajeagah, G. A., Alkhayer, G., Alomary, S. A., Ambriz-Moreno, M. J., Arias-Cruz, A., . . . Zhjeqi, V. (2023b). Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study. The Lancet Global Health, 11(2), e218–e228. https://doi.org/10.1016/s2214-109x(22)00506-x