Clinical, economic, and humanistic burden of asthma in Canada: a systematic review

BMC Pulmonary Medicine

Zhen Su⁴  Mihaela Marin³  Amyn P Sayani²  Afisi S Ismaila¹ 

[1] Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada;Medical Affairs, GlaxoSmithKline Canada, Mississauga, ON, Canada;Product Value Strategy Consulting, Optum, Burlington, Ontario, Canada;Medical Affairs, Sanofi, Cambridge, MA, USA

关键词: Quality of life;    Costs;    Burden of illness;    Literature review;    Asthma;   

Others  :  1109609
DOI  :  10.1186/1471-2466-13-70

 received in 2013-03-27, accepted in 2013-11-28,  发布年份 2013

【 摘 要 】

Background

Asthma, one of the most common chronic respiratory diseases, affects about 3 million Canadians. The objective of this study is to provide a comprehensive evaluation of the published literature that reports on the clinical, economic, and humanistic burden of asthma in Canada.

Methods

A search of the PubMed, EMBASE, and EMCare databases was conducted to identify original research published between 2000 and 2011 on the burden of asthma in Canada. Controlled vocabulary with “asthma” as the main search concept was used. Searches were limited to articles written in English, involving human subjects and restricted to Canada. Articles were selected for inclusion based on predefined criteria like appropriate study design, disease state, and outcome measures. Key data elements, including year and type of research, number of study subjects, characteristics of study population, outcomes evaluated, results, and overall conclusions of the study, were abstracted and tabulated.

Results

Thirty-three of the 570 articles identified by the clinical and economic burden literature searches and 14 of the 309 articles identified by the humanistic burden literature searches met the requirements for inclusion in this review. The included studies highlighted the significant clinical burden of asthma and show high rates of healthcare resource utilization among asthma patients (hospitalizations, ED, physician visits, and prescription medication use). The economic burden is also high, with direct costs ranging from an average annual cost of $366 to $647 per patient and a total annual population-level cost ranging from ~ $46 million in British Columbia to ~ $141 million in Ontario. Indirect costs due to time loss from work, productivity loss, and functional impairment increase the overall burden. Although there is limited research on the humanistic burden of asthma, studies show a high (31%-50%) prevalence of psychological distress and diminished QoL among asthma patients relative to subjects without asthma.

Conclusions

As new therapies for asthma become available, economic evaluations and assessment of clinical and humanistic burden will become increasingly important. This report provides a comprehensive resource for health technology assessment that will assist decision making on asthma treatment selection and management guidelines in Canada.

【 授权许可】

   
2013 Ismaila et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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