The Swedish National Airway Register (SNAR): development, design and utility to date

Abstract

Background: The Swedish National Airway Register (SNAR) was initiated in 2013 to ensure and improve the quality of care for patients with asthma and COPD. Aim: To describe the development and design of SNAR, and to study the 2019 data to evaluate its potential utility related to improvement of quality of care. Methods: SNAR includes data from patients with asthma (both children and adults) and COPD from primary, secondary and tertiary care, and also, for COPD inpatient care. Data on diagnostic investigations (e.g. spirometry, blood sample, skin prick test), symptom-scores, comorbidities and prescribed treatments are registered. The registrations are entered manually by healthcare professionals, or directly transferred from electronic medical records to a web-based platform. Results: In 2019, 1000 clinics participated and data were directly transferred by about 88% of them. The register included data on 205,833 patients with asthma and 80,372 with COPD (of these, 5% had both diagnoses). Registrations of new patients and follow-up visits from primary and secondary/tertiary care in 2019 were completed for 75,707 patients with asthma (11,818 children <12 yr, 6545 adolescents 12-17 yr, and 57,344 adults >17 yr) and 38,117 with COPD. Depending on age and disease group, 43-77% had performed spirometry, 36-65% Asthma Control Test, and 60% COPD Assessment Test. The prevalence of current smoking was about 2% in adolescents, 10% in adults with asthma, and 34% in COPD. For these, smoking cessation support was offered to 27%, 38% and 51%, respectively. Overall, limited data were available on investigation of allergy, 6-min walk test, patient education and written treatment plans. Regarding asthma, sex-differences in disease management were evident. Conclusion: SNAR has cumulatively registered data from over 270,000 individuals, and the register is important for patients, caregivers, authorities, politicians and researchers to evaluate the effect of treatment and to ensure high and equal quality of care nationwide.

Predictors of severe COVID-19 in a registry-based Swedish cohort of patients with COPD

“…Although studies have described COVID-19 cohorts and investigated COPD as a risk factor, studies investigating patients with COPD in relation to risks of COVID-19 remain rare. Approved by the Swedish Ethical Review Authority (2020-02777), the current study was based on the Swedish National Airway Register (SNAR), which includes a large, well-characterised cohort of patients with COPD [5]. In the cohort, patients who have been hospitalised or died from COVID-19 were identified, which afforded a unique opportunity to study predictors of severe COVID-19 in COPD.…”

“…Launched in 2013, SNAR comprises data on patients with a physician-diagnosis of COPD from primary and secondary care (ICD-10 J44) [5]. On 1 February 2020, 68,902 living patients with COPD were identified in SNAR.…”

Adherence to Treatment Recommendations for Chronic Obstructive Pulmonary Disease - Results from the Swedish National Airway Register

“…Data entered into the register include demography, lung function, exacerbation history, CAT score, mMRC dyspnoea scale score and pharmacological treatment. 6 …”

Benefits, for patients with late stage chronic obstructive pulmonary disease, of being cared for in specialized palliative care compared to hospital. A nationwide register study

“…This is a register study where two nationwide registers were merged, the Swedish National Airway Register (SNAR) [ 19 ] and the Swedish Register of Palliative Care (SRPC). The SNAR contains data on patients diagnosed with either COPD or asthma.…”