Abstract
BackgroundAsthma, 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.MethodsA 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.ResultsThirty-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.ConclusionsAs 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.
Highlights
IntroductionOne of the most common chronic respiratory diseases, affects about 3 million Canadians
In the first-level selection process for the clinicoeconomic burden, 503 of the 570 citations were rejected: 174 reported inappropriate outcomes, 150 due to inappropriate disease state, and 91 due to inappropriate study design
There is a paucity of research on the humanistic burden of asthma in Canada, the few studies included in this review indicate that quality of life (QoL) is unquestionably diminished in asthmatic patients and that there is a high prevalence of psychological distress and psychiatric disorders among patients with asthma
Summary
One of the most common chronic respiratory diseases, affects about 3 million Canadians. An inflammatory disorder of the airways [1], accounts for roughly 80% of cases of chronic respiratory disease in Canada [2]. It affects more than 3 million Canadians and roughly 235 million people worldwide [3,4]. According to Statistics Canada, 8.5% of the population aged 12 and older has been diagnosed with asthma [5]. Its prevalence in this country has been increasing over the last 20 years [3]. Asthma is a major cause of hospitalization [7] among the estimated 13% of Canadian children who suffer from the disease [8]
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