BackgroundThe prevalence of multiple chronic conditions (MCC), defined as several coexisting chronic conditions, has increased with the aging of society. MCC is associated with poor outcomes, but most comorbid diseases in asthma patients have been evaluated as asthma-associated diseases. We investigated the morbidity of coexisting chronic diseases in asthma patients and their medical burdens.MethodsWe analyzed data from the National Health Insurance Service-National Sample Cohort for 2002–2013. We defined MCC with asthma as a group of one or more chronic diseases in addition to asthma. We analyzed 20 chronic conditions, including asthma. Age was categorized into groups 1–5 (< 10, 10–29, 30–44, 45–64, and ≥ 65 years, respectively). The frequency of medical system use and associated costs were analyzed to determine the asthma-related medical burden in patients with MCC.ResultsThe prevalence of asthma was 13.01%, and the prevalence of MCC in asthmatic patients was 36.55%. The prevalence of MCC with asthma was higher in females than males and increased with age. The significant comorbidities were hypertension, dyslipidemia, arthritis, and diabetes. Dyslipidemia, arthritis, depression, and osteoporosis were more common in females than males. Hypertension, diabetes, COPD, coronary artery disease, cancer, and hepatitis were more prevalent in males than females. According to age, the most prevalent chronic condition in groups 1 and 2 was depression, dyslipidemia in group 3, and hypertension in groups 4 and 5. Older age, low income, and severe disability were independent risk factors for MCC in patients with asthma. The frequency of asthma-related medical system use and asthma-associated costs increased with increasing numbers of coexisting chronic diseases.ConclusionComorbid chronic diseases in asthma patients differed according to age and sex. The asthma-related-medical burdens were highest in patients with five or more chronic conditions and groups 1 and 5.

Disease prevalence and achievement/exception performance against key indicators for GP Practices as part of the Quality and Outcomes Framework (QOF). Data is presented in CSV files for the 2013/14 year onwards. For previous years, data is available in summary tables from the links provided. The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievement results. QOF is a voluntary process for all surgeries in England and was introduced as part of the GP contract in 2004. It is reported in two formats; this publication, and the on-line search function (www.qof.hscic.gov.uk) QOF awards surgeries achievement points for: managing some of the most common chronic diseases, e.g. asthma, diabetes implementing preventative measures, e.g. regular blood pressure checks the extra services offered such as child health care and maternity services the quality and productivity of the service, including the avoidance of emergency admissions to hospital compliance with the minimum time a GP should spend with each patient at each appointment Achievement information is based on practice level achievement againsts primary care indicators. Prevalence figures are based on numbers of patients on GP clinical registers for specific conditions. Exceptions data presents information on numbers of patients with specific clinical conditions who are not included in QOF indicator data used to measure achievement. There are a number of criteria to determine exception reported patients. All data are presented at GP practice, CCG, Area Team, Region and England Prevalence registers included: Atrial Fibrillation (AF) Asthma (AST) Cancer (CAN) Coronary Heart Disease (CHD) Chronic Kidney Disease (CKD) Chronic Obstructive Pulmonary Disease (COPD) Cardiovascular Disease - Primary Prevention (CVDPP) Dementia (DEM) Depression (DEP) Diabetes (DM) Epilepsy (EP) Heart Failure (HF) Heart Failure due to LVD (HF) Hypertension (HYP) Learning Disabilities (LD) Mental Health (MH) Obesity (OB) Osteoporosis (OST) Peripheral Atrial Disease (PAD) Palliative Care (PC) Rheumatoid Arthritis (RA) Smoking Indicators (SMOK) Stroke (STIA) Thyroid (THY)

Age-adjusted prevalence of comorbid chronic conditions in asthma patients by sex.