Asthma and COPD rates are keeping fairly stable, but adherence to asthma medication is dropping, new stats show.
The number of people taking biologics for asthma has tripled in four years, while adherence to asthma medication is falling, according to the latest Australian data.
The new report from the Australian Institute of Health and Welfare shows that the overall prevalence of both asthma and COPD has been stable for 21 years.
Fewer people are visiting emergency departments or dying because of their asthma (from 297 per 100,000 in 2018-19 to 232 in 2020-21), and rates of asthma-related hospitalisations have also dropped since 2017.
But fewer people with asthma have good adherence to preventer medication, with adherence falling to 31% in 2022-23 from 33% in 2017-18.
Adherence to biologic therapies is stable, apart from a slight downward trend among people aged 34 years and under.
And between 2018–19 and 2022–23, the number of people dispensed at least one biologic more than tripled from 810 to 2900.
Overall, asthma control is getting better. In 2022-23, 27% of people aged 40 years and under were considered to have poor asthma control compared with 29% in 2017-18 (based on their use of reliever medication).
More males (29%) had poor asthma control than females (26%).
For people aged 35 to 40 years, 31% had poor asthma control, which was higher than for all other age groups.
“Rates have changed little since 2017–18, apart from spikes in 2019–20 and 2020–21 likely related to the 2019 bushfires and covid-19 pandemic,” the authors said.
Overall, the prevalence of asthma remained relatively stable over 21 years, at 12% in 2001 and 11% in 2022.
Asthma is the leading cause of disease burden for children aged one to four (11%) and five to nine (13%). Prevalence was higher among boys aged 0-14, but higher among females over 15.
“This change in prevalence for males and females over the age of 15 is likely to be due to a complex interaction between changing airway size and hormonal changes that occur during adolescent development, as well as differences in environmental exposures,” the AIHW authors said.
Around 65% of people with asthma also had one or more other chronic condition, and 41% had a mental or behavioural condition.
While asthma rates don’t vary according to different socioeconomic areas, chronic obstructive pulmonary disease (COPD) is far more common in rural and remote areas and in disadvantaged areas.
Related
The new report also shows that almost nine out of 10 people with COPD have another chronic condition, and the disease accounts for 1% of all GP appointments.
Around 638,000 Australians have COPD – 2.5% of the population, but 10% of those aged 85 years and over.
Prevalence of COPD has remained stable over 10 years, barely shifting between 2011–12 (2.3%) and 2022 (2.2%).
Last year, COPD caused half of the total burden of all respiratory diseases in Australia, 71% of fatal burden and 3.6% of the total disease burden. In 2022, COPD caused 4% of all deaths in Australia.
The disease affects slightly more women than men.
In 2021–22, there were 53,000 hospitalisations with a principal diagnosis of COPD for people aged 45 years and over.
Of people with COPD, 87% had at least one other chronic condition, most commonly mental or behavioural conditions (49%), arthritis (45%), and asthma and back problems (both 42%).
Australian Institute of Health and Welfare, 27 November 2024
