Asthma

This British Thoracic Society (BTS) Clinical Statement addresses occupational asthma and includes key clinical practice points. In an era in which medical practice is increasingly determined by evidence-based guidelines, it must be acknowledged from the outset that there is little or no published evidence for some of the areas covered in this statement; thus, much of the advice is based on expert opinion and accumulated clinical experience.

Asthma is the most common respiratory disorder in the UK, yet we have incomplete knowledge on the prevalence of current disease, treatment and exacerbations.

We used UK electronic healthcare records, 2006–2016, to estimate the prevalence of current asthma by year, sex and age (<5, 5–11, 12–17, 18–24, 25–54 and ≥55 years), and the proportion prescribed inhaled corticosteroids (ICS) and additional asthma therapy, treated for exacerbations and other asthma care markers.

Currently the National Asthma and COPD audit programme (NACAP) only undertakes audit of COPD primary care in Wales due to its near complete data coverage. We aimed to determine if the quality of COPD primary care in the other UK nations is comparable with Wales.

Rationale: Asthma is heterogeneous and knowledge on exacerbation patterns is lacking. Previous studies have had a relatively short follow-up or focused on severe disease.

Objectives: To describe exacerbation patterns over a prolonged follow-up in a population that includes patients of all disease severity.