Impact of Socioeconomic Status on Adult Patients with Asthma: A Population-Based Cohort Study from UK Primary Care

Busby, John; Price, David; Al-Lehebi, Riyad; Bosnic‐Anticevich, Sinthia; Boven, Job F M van; Emmanuel, Benjamin; FitzGerald, J. Mark; Gaga, Mina; Hansen, Susanne; Hew, Mark; Iwanaga, Takashi; Linnemann, Desirée Larenas; Mahboub, Bassam; Mitchell, Patrick; Morrone, Daniela; Pham, Jonathan; Porsbjerg, Celeste; Roche, Nicolás; Wang, Eileen; Eleangovan, Neva; Heaney, Liam G.

doi:10.2147/jaa.s326213

Cited by 24 publications

(14 citation statements)

References 43 publications

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“…Ethnic disparities in the provision of asthma care have been reported by several previous studies 22 , 29 and this is also a significant finding in the current study, particularly among Black ethnic groups. Previous literature suggests that this disparity is because of differences in health-seeking behaviour 30 and less familiarity with primary healthcare services 31 among these population groups.…”

Section: Discussionsupporting

confidence: 84%

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Punyadasa,

Simms-Williams,

Adderley

et al. 2023

Br J Gen Pract

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Background: Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge. Aim: We evaluated post-hospitalisation asthma management in primary care and its associations with patient characteristics. Design and setting: A retrospective cohort study was performed using English primary care data from the Clinical Practice Research Datalink Aurum database and linked Hospital Episode Statistics Admitted Patient Care data. Method: Patients with asthma aged ≥5 years who had at least one asthma-related hospitalisation from 1st January 2017 to 31st December 2019 were included. The primary outcome was a composite of any of the following delivered in primary care within 28 days from hospital discharge: asthma review, asthma management plan, asthma medication prescriptions, demonstration of inhaler technique, or smoking cessation counselling. The association between patient characteristics and delivery of clinical care was assessed using logistic regression. Results: The study included 17,457 patients. 10,515 (60.2%) patients received the primary outcome within 28 days of hospital discharge. 2311 (13.2%) received an asthma review, 1459 (8%) an asthma management plan, 9996 (57.3%) an asthma medication, 1500 (8.6%) a demonstration of inhaler technique, and 52 (1.2% of smokers) had smoking cessation counselling. Patients from black ethnic minorities received less of this care (27-54% lower odds, depending on age). However, short-acting bronchodilator prescriptions in the previous year were associated with an increased likelihood of the primary outcome. Conclusion: A significant proportion of patients do not receive timely follow-up in primary care following asthma-related hospitalisations, particularly among black ethnic groups.

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Section: Discussionsupporting

confidence: 84%

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Punyadasa,

Simms-Williams,

Adderley

et al. 2023

Br J Gen Pract

View full text Add to dashboard Cite

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“…On the other hand, the link might reflect a temporal association without direct causation, where ADHD and asthma appear together more frequently due to shared genetic markers 63 or environmental factors 64 without one condition causing the other, although ADHD symptoms may manifest first. Additionally, an unobserved factor like socio-economic status could confound the relationship, suggesting a link where none exists 65 , 66 .…”

Section: Discussionmentioning

confidence: 99%

Inferring skin–brain–skin connections from infodemiology data using dynamic Bayesian networks

Scutari,

Kerob,

Salah

2024

Sci Rep

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The relationship between skin diseases and mental illnesses has been extensively studied using cross-sectional epidemiological data. Typically, such data can only measure association (rather than causation) and include only a subset of the diseases we may be interested in. In this paper, we complement the evidence from such analyses by learning an overarching causal network model over twelve health conditions from the Google Search Trends Symptoms public data set. We learned the causal network model using a dynamic Bayesian network, which can represent both cyclic and acyclic causal relationships, is easy to interpret and accounts for the spatio-temporal trends in the data in a probabilistically rigorous way. The causal network confirms a large number of cyclic relationships between the selected health conditions and the interplay between skin and mental diseases. For acne, we observe a cyclic relationship with anxiety and attention deficit hyperactivity disorder (ADHD) and an indirect relationship with depression through sleep disorders. For dermatitis, we observe directed links to anxiety, depression and sleep disorders and a cyclic relationship with ADHD. We also observe a link between dermatitis and ADHD and a cyclic relationship between acne and ADHD. Furthermore, the network includes several direct connections between sleep disorders and other health conditions, highlighting the impact of the former on the overall health and well-being of the patient. The average $$R^2$$ R 2 for a condition given the values of all conditions in the previous week is 0.67: in particular, 0.42 for acne, 0.85 for asthma, 0.58 for ADHD, 0.87 for burn, 0.76 for erectile dysfunction, 0.88 for scars, 0.57 for alcohol disorders, 0.57 for anxiety, 0.53 for depression, 0.74 for dermatitis, 0.60 for sleep disorders and 0.66 for obesity. Mapping disease interplay, indirect relationships, and the key role of mediators, such as sleep disorders, will allow healthcare professionals to address disease management holistically and more effectively. Even if we consider all skin and mental diseases jointly, each disease subnetwork is unique, allowing for more targeted interventions.

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“…Another research project, Relationship between Socioeconomic Status and Asthma Outcome (RADIANT), sheds light on the association between socioeconomic status and clinical outcomes in severe asthma patients [89]. Patients who were most socioeconomically deprived were more likely to have uncontrolled asthma or exacerbations than those who were least deprived, yet the rates of respiratory referrals remained similar; this suggests that more deprived patients may have greater need for specialist reviews and biologic treatment [90].…”

Section: The Role Of the International Severe Asthma Registrymentioning

confidence: 99%

Biologics in severe asthma: the role of real-world evidence from registries

et al. 2022

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Asthma is one of the most common noncommunicable diseases; in the majority of patients it is well controlled with inhaled bronchodilators and inhaled corticosteroids, but the management of severe asthma has been a significant challenge historically. The introduction of novel biologic drugs in the past few decades has revolutionised the field, presenting physicians with a variety of biologic drugs with different mechanisms for the treatment of severe asthma.It is of crucial importance to evaluate the effectiveness of these drugs by following their “real-life” effectiveness rather than relying solely on their efficacy, established in carefully designed clinical trials, which therefore do not necessarily match the profile of the real-life patient. Understanding the actual effectiveness of the specific drugs in real-life patients is a crucial part of tailoring the right drugs to the right patients. Registries serve as an important tool in obtaining real-life evidence, since they are in effect observational studies, following the entire patient population.

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Impact of Socioeconomic Status on Adult Patients with Asthma: A Population-Based Cohort Study from UK Primary Care

Cited by 24 publications

References 43 publications

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Inferring skin–brain–skin connections from infodemiology data using dynamic Bayesian networks

Biologics in severe asthma: the role of real-world evidence from registries

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