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Incidence and prevalence of asthma, chronic obstructive pulmonary disease and interstitial lung disease between 2004 and 2023: harmonised analyses of longitudinal cohorts across England, Wales, South-East Scotland and Northern Ire...

Hannah Whittaker Orcid Logo, Adriana Kramer Fiala Machado Orcid Logo, Sara Hatam, Sarah Cook, Sean Scully, Hywel Evans Orcid Logo, Thomas Bolton, Constantinos Kallis Orcid Logo, John Busby Orcid Logo, Liam G Heaney, Aziz Sheikh, Jennifer K Quint Orcid Logo

Thorax

Swansea University Authors: Sean Scully, Hywel Evans Orcid Logo

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DOI (Published version): 10.1136/thorax-2024-222699

Abstract

Background: We describe the epidemiology of asthma, chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) from 2004 to 2023 in England, Wales, Scotland and Northern Ireland (NI) using a harmonised approach. Methods: Data from the National Health Service England (NHSE), Cli...

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Published in: Thorax
ISSN: 0040-6376 1468-3296
Published: BMJ Publishing Group 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69254
Abstract: Background: We describe the epidemiology of asthma, chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) from 2004 to 2023 in England, Wales, Scotland and Northern Ireland (NI) using a harmonised approach. Methods: Data from the National Health Service England (NHSE), Clinical Practice Research Datalink Aurum in England, Secure Anonymised Information Linkage Databank in Wales, DataLoch in South-East Scotland and the Honest Broker Service in NI were used. A harmonised approach to COPD, asthma and ILD case definitions, study designs and study populations across the four nations was performed. Age-sex-standardised incidence rates and point prevalence were calculated between 2004 and 2023 depending on data availability. Logistic and negative binomial regression compared incidence and prevalence rates between the start and end of each study period. Linear extrapolation projected incidence rates between 2020 and 2023 to illustrate how observed and projected rates differed. Results: Incidence rates were lower in 2019 versus 2005 for asthma (England: incidence rate ratio 0.89, 95% CI 0.88 to 0.90; Wales: 0.66, 0.65 to 0.68; Scotland: 0.67, 0.64 to 0.71; NI: 0.84, 0.81 to 0.86), COPD (England: 0.83, 0.82 to 0.85; Wales: 0.67, 0.65 to 0.69) and higher for ILD (England: 3.27, 3.05 to 3.50; Wales: 1.39, 1.27 to 1.53; Scotland: 1.63, 1.36 to 1.95; NI: 3.03, 2.47 to 3.72). In NHSE, the incidence of asthma was similar in June 2023 versus November 2019, but lower for COPD and higher for ILD. Prevalence of asthma in 2019 in England, Wales, Scotland and NI was 9.7%, 15.9%, 13.2% and 7.0%, respectively, for COPD 4.5%, 5.1%, 4.4% and 3.0%, and for ILD 0.4%, 0.5%, 0.6% and 0.3%. Projected incidence rates were 2.8, 3.4 and 1.8 times lower for asthma, COPD and ILD compared with observed rates at the height of the pandemic. Interpretation: Asthma, COPD and ILD affect over 10 million people across the four nations, and a substantial number of diagnoses were missed during the pandemic.
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was partly funded by BREATHE-The Health Data Research Hub for Respiratory Health (MC_PC_19004) and the Health Data Research (HDR) UK Inflammation and Immunity programmes (DRUK2023.0027). In addition, an NIHR BRC grant funded access to the British Heart Foundation Data Science Centre for use of the NHSE SDE data (BRC RS Pil PSO767). The British Heart Foundation Data Science Centre (grant No SP/19/3/34678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS England) of the Secure Data Environment service for England, provision of linked data sources, data access, user software licences, computational usage and data management and wrangling support, with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser’s National Core Studies programme to coordinate national COVID-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists and clinicians. This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref: MC_PC_20058).

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