UK hospital admissions for COPD and asthma have significantly increased over the last 21 years despite an increase in prescribed treatments
In an analysis of hospital admissions for both chronic obstructive pulmonary disease (COPD) and asthma from 1999 to 2020, it was found that there was a significant increase for both conditions despite a considerable increase in prescribed treatments for these diseases.
Both COPD and asthma are common respiratory diseases. In a recent global systematic review it was estimated that some 391·9 million people had COPD in 2019 and the World Health Organisation (WHO) estimates than in 2019, there were 3.23 million global deaths from COPD. Asthma also affects a huge number of people and WHO estimated that in 2019, the disease affected some 262 million people across the world and led to 455,000 deaths. With both diseases leading to a considerable number of deaths, in the present study, a team of Saudi Arabian researchers examined the trends in hospital admissions and which could result in death, for both COPD and asthma between 1999 and 2020. The researchers extracted information from the hospital episode statistics database in England and the corresponding database was Wales. In addition to hospital admissions data, the team also collected information on COPD and asthma-related medicines prescribed between 2004 and 2020.
Hospital admissions for COPD and asthma
The total annual number of admissions for the two conditions rose by 82.2% between 1999 and 2020 which represented a 59.1% increase in the hospital admission rate over this period of time (p < 0.05).
The most common reason for COPD admission (38.7%) was in combination with an acute lower respiratory tract infection and which increased by 198.5% between 1999 and 2020. In contrast, acute exacerbations of COPD alone, accounted for a quarter of admissions (25.5%) and this rate had actually reduced by 4.8% between 1999 and 2020. As with COPD, asthma additions also increased by 46.1% over the 21-year period.
Just over a third (34.7%) of COPD and asthma admissions occurred in those age 75 years and older with just under a quarter (23.5%) in those aged 15 – 59 years. Interestingly, slightly more than half (53.8%) of admissions for both conditions occurred in women.
When looking at prescriptions, the researched observed a 42.2% increase the absolute number of COPD and asthma-related dispensed medicines between 2004 and 2020, which represented a 27.2% increase between the two periods of time (p < 0.05).
The authors concluded that while the data showed a clear rise in hospital admissions for both conditions the reasons behind these increases were unclear and they called for further research to try and better understand the factors responsible for these higher rates.
Alwafi H et al. Trends in hospital admissions and prescribing due to chronic obstructive pulmonary disease and asthma in England and Wales between 1999 and 2020: an ecological study. BMC Pulm Med 2023