title: A cross-sectional assessment of the prevalence and burden of mild asthma in urban China using the 2010, 2012, and 2013 China National Health and Wellness Surveys.
abstract: OBJECTIVE
  To estimate the prevalence of mild asthma in urban China and to measure the association between asthma severity and quality of life (QOL), work productivity, and healthcare resource use.
  
  
  METHODS
  Data were from the China National Health and Wellness Surveys (NHWS) conducted between 2010 and 2013 (N = 59,935), Internet-based surveys of adults in urban China. Patients were categorized by asthma severity according to self-report and Global Initiative for Asthma (GINA2014) guidelines via self-reported medication use (mild [GINA 1-2] vs moderate/severe [GINA 3-4]). Propensity scores were used to identify matched controls without asthma. These three groups (mild vs. moderate/severe vs. matched control) were compared with respect to QOL (revised Short Form-12/36), work productivity (WPAI questionnaire), and healthcare use using generalized linear models.
  
  
  RESULTS
  1,191 respondents reported an asthma diagnosis (1.99%). Then 455 (0.77% and 76.86% of the total sample and asthma sample which could be categorized based on GINA2014 guidelines, respectively) and 897 (1.50% and 75.31% of the total and asthma sample, respectively) had mild asthma based on GINA2014 guidelines and self-report, respectively. Compared with matched controls, mild patients based on GINA2014 guidelines reported worse QOL (Physical Component Summary = 44.67 vs. 48.97), more overall work impairment (54.51% vs. 34.35%), and more all-cause emergency room visits in the past 6 months (1.95 vs. 0.63 visits) (all p <.05). Similar results were observed using self-reported severity.
  
  
  CONCLUSIONS
  Most patients with asthma in the China NHWS are mild according to either definition. Asthma patients experience significant burden to QOL, work productivity, activity impairment, and healthcare resource use.
authors.affiliation: a Global Medical Affairs , AstraZeneca, Gothenburg, Mölndal , Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Ding
authors.affiliation: b Health Outcomes Practice, Kantar Health , New York , NY , USA.
authors.forename: Marco
authors.initials: M
authors.lastname: DiBonaventura
authors.affiliation: a Global Medical Affairs , AstraZeneca, Gothenburg, Mölndal , Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Karlsson
authors.affiliation: c Medical Affairs China, AstraZeneca , Shanghai , China.
authors.forename: Xia
authors.initials: X
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004526:Efficiency; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult
keywords: Activity impairment; healthcare resource use; quality of life; severity; work productivity