title: Severe and non-severe asthma in the community: A large electronic database analysis.
abstract: A large electronic database analysis was conducted in a community of 351,799 people, ages 20-70 years to determine the prevalence and clinical characteristics of severe asthma, according to 2014 international guidelines and healthcare utilization.
  
  
  
  Severe asthmatics were grouped into controlled severe-asthma and uncontrolled severe-asthma and additional subgroups of uncontrolled severe asthma on the basis of medications dispensed. Non-asthmatic population at the same ages served as controls.
  
  
  
  A total of 19,991 (5.68%) were diagnosed as asthmatic, of which 4.65% had severe asthma. Of these, one-third was uncontrolled severe-asthma. Controlled severe-asthma group was similar to non-severe asthma and non-asthmatics in the rate of emergency room visits (21.5%, 22%, and 20%, respectively) and to all cause hospitalizations (7.4%, 7.4%, and 6.4%, respectively). Uncontrolled severe-asthmatics had significantly more hospitalizations (RR = 2.9) than controlled severe-asthmatics. Only 19.2% of uncontrolled-severe asthmatics had IgE testing and 3.6% were dispensed omalizumab.
  
  
  
  The prevalence of severe asthma is slightly less than 5% of all asthmatics. Controlling severe asthma is crucial to reducing healthcare utilization. A simple electronic database analysis, based on dispensed medications, can help healthcare providers identify subgroups of uncontrolled severe asthmatics that require focused efforts.
  
  
  
  NCT01961258. Ethics Committee approval: 032/2013C.
authors.affiliation: Department of Pulmonary Medicine, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Asthma Care & Education Unit, Meir Medical Center, Kfar Saba, Israel. Electronic address: varsanos@bezeqint.net.
authors.forename: Shabtai
authors.initials: S
authors.lastname: Varsano
authors.affiliation: Clalit Health Services, Sharon-Shomron Medical District Headquarters, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Segev
authors.affiliation: Department of Pulmonary Medicine, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents