Primary end-point |
Risk-domain asthma control includes all of the following: |
1. No asthma-related# hospital attendance or admission, ED attendance, out-of-hours attendance, or outpatient hospital attendance, and |
2. No GP consultation for lower respiratory tract infection¶ with resultant antibiotic prescription¶, and |
3. No prescription for acute course of oral corticosteroids |
Secondary end-points |
Number of severe exacerbations+, defined as any of the following [31]: |
1. Asthma-related# hospital attendance or admission or ED attendance, or |
2. Acute course of oral corticosteroids |
Number of acute respiratory events, defined as any of the following: |
1. Asthma-related# hospital attendance or admission or ED attendance, or |
2. Acute course of oral corticosteroids, or |
3. GP consultation for lower respiratory tract infection¶ |
Treatment stability, includes all of the following: |
1. Asthma control (primary end-point, see above) and |
2. No treatment change, defined additional therapy or change in therapy as |
a) Increased ICS dose (by ≥50%), or |
b) Use of additional therapy, such as LABA, LTRA or theophylline |
Matching criteria: patients were matched at the index prescription date by |
1. Sex (male/female) |
2. Age (±5 years) |
3. Last ICS daily dose prescribed before index date prescription (categorised as 1–50 μg/51–100 μg/101–200 μg/201–300 μg/301–400 μg/>400 μg in extrafine beclomethasone equivalents§) |
4. Asthma control (defined as primary end-point) during baseline year (controlled/not controlled) |
5. Mean SABA daily dose during baseline yearƒ (categorised as 0 μg/1–200 μg/201–400 μg/>400 μg) |
6. Asthma consultation(s) without severe exacerbation (0/1/≥2) |
ED: emergency department; GP: general practitioner; ICS: inhaled corticosteroid; LABA: long-acting β2-agonist; LTRA: leukotriene receptor antagonist; SABA: short-acting β2-agonist. #: defined as all events with a lower respiratory code, including all asthma codes and lower respiratory tract infection codes; ¶: identified as GP consultations with a code for lower respiratory tract infection Read code in the database; +: hospital attendance/admission and/or an oral corticosteroid course within a 2-week window were considered as one exacerbation; §: doses of budesonide and the large-particle beclomethasone (Clenil Modulite, Chiesi, Manchester, UK) were halved, and fluticasone doses of 250 μg and 500 μg were treated as equivalent to extrafine-particle beclomethasone 200 and 400 μg; ƒ: SABA daily dose was defined as total prescribed SABA during baseline year divided by 365. Reproduced from [19] with permission from the publisher.