Bronchiectasis is a chronic lung condition characterised by symptoms of cough productive of sputum (including coughing up blood), breathlessness and recurrent chest infections which sometimes require prolonged courses of antibiotics or even hospital admission. Previous studies have investigated bronchiectasis using routine data in the UK, but it is not currently known how common bronchiectasis is in England, or the health burden of the disease with respect to hospitalisations or development of other co-morbidities. We know that it is a disease that is often associated with other conditions, but we do not know what the impact of having these other conditions is on bronchiectasis. We will therefore also explore the health burden of the disease with respect to hospitalisations or development of other diseases (e.g. cardiovascular disease) in people who have bronchiectasis in addition to other chronic diseases such as asthma, chronic obstructive pulmonary disease and autoimmune diseases.
This work will tell us how common bronchiectasis is in England and how common other diseases are in people with Bronchiectasis and how commonly occurring other conditions in addition to bronchiectasis affect the prognosis and natural history of bronchiectasis. We will measure incidence, prevalence, mortality and co-morbidity incidence overall and by the specific subgroups. We will explore this using linked primary and secondary care data. This will help us to better understand how common the disease is now, and who is potentially at risk of more severe disease. It will also help healthcare professionals know who may be at risk of severe disease.
Bronchiectasis is a chronic lung condition characterised by symptoms of cough productive of sputum (including coughing up blood), breathlessness and recurrent chest infections which sometimes require prolonged courses of antibiotics or even hospital admission. Whilst previous studies have investigated incidence and prevalence of bronchiectasis using CPRD data, these are now out of date. There are also limited studies exploring the natural history of bronchiectasis with respect to other chronic commonly co-occurring conditions.
We aim to provide up to date incidence and prevalence figures over the last 5 years as well as describing the healthcare burden in this population by exploring rates of bronchiectasis exacerbations (defined in primary care or by hospital admission) and the incidence of commonly occurring co-morbidities (e.g. cardiovascular disease) and how these differ by underlying exacerbation frequency. Among subgroups of people with bronchiectasis (those with co-morbid chronic obstructive pulmonary disease ((COPD), asthma or autoimmune disorders) we will also explore exacerbations and commonly occurring co-morbidities and compare the occurrence of these in people with bronchiectasis alone or asthma or COPD alone. This will include rates of exacerbation (inpatient and GP), outpatient management and mortality. We will use CPRD Aurum linked with HES APC, OP, IMD and ONS mortality data. We will use descriptive statistics, calculate incidence and prevalence and use negative binomial or Poisson regression to explore exacerbation rates. This information will help to inform disease burden and healthcare planning.
• incidence and prevalence of bronchiectasis
• rates of exacerbations
• incidence of cardiovascular disease, lung cancer, anxiety, depression
• mortality rates
Jennifer Quint - Chief Investigator - Imperial College London
Constantinos Kallis - Corresponding Applicant - Imperial College London
Leah Deshler - Collaborator - Imperial College London
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation