Public health insights of patients with asthma receiving primary, specialist or mixed care in Singapore using data from the SDG-CARE Asthma Registry.

PURPOSE: The prevalence and economic burden of asthma across the public healthcare landscape in Singapore is substantial, where the asthma patient journey often transitions between primary care (PC) and specialty care (SC) settings. PATIENTS AND METHODS: This study used the SingHealth COPD and Asthma Data Mart, a repository of clinical and administrative data from patients with asthma or chronic obstructive pulmonary disease, to collect real-time, real-world data across a range of demographics, disease severities and treatment pathways. RESULTS: Key differences were identified among patients treated in PC, SC, or both (PC/SC). There were more patients of Chinese ethnicity and ex-smokers among those treated in SC versus PC or PC/SC. Patients in SC also had a lower mean Asthma Control Test score (17.93 [standard deviation: 4.92]) versus the other groups (PC: 20.32 [4.37], p < 0.001; PC/SC: 19.65 [4.55], p < 0.001). More patients used low-dose inhaled corticosteroids in the PC (76.95 %) than SC group (60.1 %). Patients treated in PC/SC were older and had more frequent emergency department visits (0.54 [1.17] vs PC: 0.04 [0.16], p < 0.001; SC: 0.35 [0.92], p < 0.001) and exacerbations per patient/year (2.31 [3.37] vs PC: 1.48 [2.56], p < 0.001; SC: 0.96 [2.67], p < 0.001), and higher proportions had comorbidities versus PC or SC. Overall, nearly half of patients had uncontrolled asthma, 58.88 % of whom were in the PC group. CONCLUSION: Findings of this study provide greater understanding of the asthma public healthcare landscape in Singapore, allowing for the identification of current gaps in care, particularly for high-risk groups that may benefit from optimised treatment.

Duke Scholars

Author David Bruce Matchar Medicine, General Internal Medicine