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Asthma exacerbations in New Zealand 2010-2019

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Authors:
Summary:

A national population-based study has shown that asthma exacerbation rates have increased over the period 2010 to 2019, but hospitalisation rates have decreased. The study retrospectively examined de-identified data from five national healthcare datasets. Exacerbations were defined based on hospital discharge diagnoses or oral corticosteroid dispensing. The total number of patients with asthma was 447,797 in 2010 and 512,627 in 2019, equating to approximately 10% of the population. The asthma exacerbation rate was 19.4% (376.2 per 1000 patient years) in 2010 and 25.1% (438.3 per 1000 patient-years) in 2019. Exacerbations rates were consistently higher in females, Pacific peoples and Māori. Hospital admissions decreased from 1.4% in 2010 to 0.9% in 2019, however over 50% of admissions were in Māori and Pacific peoples. The study authors concluded that their findings suggest a move away from secondary to primary care management of asthma exacerbations.

Comment:
Much of the work to improve asthma outcomes in Aotearoa has focussed on community management, including the introduction of healthy homes legislation, asthma guidelines and PHARMAC funding of combination therapy. Importantly, these three activities aligned with the principle of Te Tiriti, particularly tino rangatiratanga (Māori leaders), equity and active protection. Wonderful to see these contributing to better outcomes.
Reference: Respir Med. 2023;217:107365.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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