Brunel University Research Archive (BURA) >
College of Health and Life Sciences >
Dept of Clinical Sciences >
Dept of Clinical Sciences Research Papers >

Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/4758

Title: Deaths certified as asthma and use of medical services: A national case-control study
Authors: Sturdy, PM
Butland, BK
Anderson, HR
Ayres, JG
Bland, JM
Harrison, BDW
Peckitt, C
Victor, CR
Publication Date: 2005
Publisher: BMJ
Citation: Thorax, 60(11): 909-915, Nov 2005
Abstract: Background: Studies have linked asthma death to either increased or decreased use of medical services. Methods: A population based case-control study of asthma deaths in 1994–8 was performed in 22 English, six Scottish, and five Welsh health authorities/boards. All 681 subjects who died were under the age of 65 years with asthma in Part I on the death certificates. After exclusions, 532 hospital controls were matched to 532 cases for age, district, and date of asthma admission/death. Data were extracted blind from primary care records. Results: The median age of the subjects who died was 53 years; 60% of cases and 64% of controls were female. There was little difference in outpatient attendance (55% and 55%), hospital admission for asthma (51% and 54%), and median inpatient days (20 days and 15 days) in the previous 5 years. After mutual adjustment and adjustment for sex, using conditional logistic regression, three variables were independently associated with asthma death: fewer general practice contacts (odds ratio 0.82 (95% confidence interval (CI) 0.74 to 0.91) per 5 contacts) in the previous year, more home visits (1.14 (95% CI 1.08 to 1.21) per visit) in the previous year, and fewer peak expiratory flow recordings (0.83 (95% CI 0.74 to 0.92) per occasion) in the previous 3 months. These associations were similar after adjustment for markers of severity, psychosocial factors, systemic steroids, short acting bronchodilators and antibiotics, although the association with peak flow was weakened and just lost significance. Conclusion: Asthma death is associated with less use of primary care services. Both practice and patient factors may be involved and a better understanding of these may offer possibilities for reducing asthma death.
Description: This is an open access publication. The official published version can be accessed from the link below.
Sponsorship: This study was funded jointly between the National Research and Development Asthma Management Programme (contract number AM1/ 05/002) and the National Asthma Campaign through a grant from Glaxo Wellcome (now GlaxoSmithKline).
URI: http://thorax.bmj.com/content/60/11/909.abstract
http://bura.brunel.ac.uk/handle/2438/4758
DOI: http://dx.doi.org/10.1136/thx.2004.025593
ISSN: 0040-6376
Appears in Collections:Community Health and Public Health
Dept of Clinical Sciences Research Papers

Files in This Item:

File Description SizeFormat
Fulltext.pdf93.26 kBAdobe PDFView/Open

Items in BURA are protected by copyright, with all rights reserved, unless otherwise indicated.