Burden of Pertussis in Individuals with a Diagnosis of Asthma: A Retrospective Database Study in England

Amit Bhavsar; Emmanuel Aris; Lauriane Harrington; Jason C Simeone; Anna Ramond; Dimitra Lambrelli; Alberto Papi; Louis-Philippe Boulet; Kinga Meszaros; Nicolas Jamet; Yan Sergerie; Piyali Mukherjee

doi:10.2147/JAA.S335960

Burden of Pertussis in Individuals with a Diagnosis of Asthma: A Retrospective Database Study in England

J Asthma Allergy. 2022 Jan 11:15:35-51. doi: 10.2147/JAA.S335960. eCollection 2022.

Authors

Affiliations

¹ Europe Medical Affairs, GSK, Wavre, Belgium.
² Real-World Analytics, GSK, Wavre, Belgium.
³ Global Medical Affairs, GSK, Wavre, Belgium.
⁴ Real-World Evidence, Evidera Inc., Waltham, MA, USA.
⁵ Real-World Evidence, Evidera Ltd, London, UK.
⁶ Respiratory Medicine, University of Ferrara, Ferrara, Italy.
⁷ Department of Medicine, Laval University, Quebec City, Quebec, Canada.
⁸ Value Evidence and Outcomes, GSK, Wavre, Belgium.

Abstract

Purpose: The impact of pertussis in individuals with asthma is not fully understood. We estimated the incidence, health care resource utilization (HCRU), and direct medical costs (DMC) of pertussis in patients with asthma.

Patients and methods: In this retrospective cohort study, the incidence rate of pertussis (identified using diagnostic codes) among individuals aged ≥50 years with an asthma diagnosis was assessed during 2009-2018 using Clinical Practice Research Datalink and Hospital Episode Statistics databases. HCRU and DMC were compared - between patients with diagnoses of asthma and pertussis (asthma+/pertussis+) and propensity score-matched patients with a diagnosis of asthma without pertussis (asthma+/pertussis-) - in the months around the pertussis diagnosis (-6 to +11).

Results: Among 687,105 individuals, 346 had a reported pertussis event (incidence rate: 9.6/100,000 person-years of follow-up; 95% confidence interval: 8.6-10.7). HCRU and DMC were assessed among 314 asthma+/pertussis+ patients and 1256 matched asthma+/pertussis- controls. Baseline HCRU was similar in both cohorts, but increases were observed in the asthma+/pertussis+ cohort from -6 to -1 month before to 2-5 months after diagnosis. Rates of accident and emergency visits, general practitioner (GP)/nurse visits, and GP prescriptions were 4.3-, 3.1-, and 1.3-fold, respectively, in the asthma+/pertussis+ vs asthma+/pertussis- cohorts during the month before diagnosis; GP/nurse visit rates were 2.0- and 1.2-fold during 0-2 and 2-5 months after diagnosis, respectively (all p<0.001). DMC was 1.9- and 1.6-fold during the month before and 2 months from diagnosis, respectively, in the asthma+/pertussis+ vs asthma+/pertussis- cohorts (both p<0.001). During months -1 to +11, DMC in the asthma+/pertussis+ cohort was £370 higher than in the asthma+/pertussis- controls.

Conclusion: A pertussis diagnosis among adults aged ≥50 years with asthma resulted in significant increases in HCRU and DMC across several months around diagnosis, suggesting lengthy diagnosis times and highlighting the need for prevention strategies.

Keywords: asthma; direct medical costs; health care resource utilization; incidence; pertussis.

Grants and funding

GlaxoSmithKline Biologicals SA funded this study (study number HO-18-19690) and was involved in all stages of study conduct, including analysis of the data. GlaxoSmithKline Biologicals SA also took in charge all costs associated with the development and publication of this manuscript.