Send to

Choose Destination
Respirology. 2017 Nov;22(8):1570-1578. doi: 10.1111/resp.13123. Epub 2017 Aug 9.

Is higher population-level use of ICS/LABA combination associated with better asthma outcomes? Cross-sectional surveys of nationally representative populations in New Zealand and Australia.

Author information

Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia.
Department of Medicine, University of Otago, Christchurch, New Zealand.
Respiratory Services, Canterbury District Health Board, Christchurch, New Zealand.
Department of Medicine, University of Otago, Wellington, New Zealand.
Department of Respiratory Medicine, Concord Hospital and Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.
Department of Paediatrics, The University of Melbourne and Murdoch Childrens Research Institute, Royal Children's Hospital Centre for Adolescent Health, Melbourne, VIC, Australia.



New Zealand (NZ) and Australia (AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries.


A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions. Symptom control was assessed with the Asthma Control Test (ACT). Healthcare utilization was assessed from reported urgent doctor/hospital visits in the previous year.


NZ (n = 537) and Australian (n = 2686) participants had similar age and gender distribution. More NZ than Australian participants used inhaled corticosteroid (ICS)-containing medication (68.8% vs 60.9%; P = 0.006) but ICS/long-acting β2 -agonist (LABA) constituted 44.4% of NZ and 81.5% of Australian total ICS use (P < 0.0001). Adherence was higher with ICS/LABA than ICS-alone (P < 0.0001), and higher in NZ than in AU (P < 0.0001). ACT scores were similar (P = 0.41), with symptoms well controlled in 58.6% and 54.4% participants, respectively. More NZ participants reported non-urgent asthma reviews (56.6% vs 50.4%; P = 0.009). Similar proportions had urgent asthma visits (27.9% and 28.6%, respectively, P = 0.75).


This comparison, which included the first nationally representative data for asthma control in NZ, showed that poorly controlled asthma is common in both NZ and AU, despite subsidized ICS-containing medications. The greater use of ICS-alone in NZ relative to ICS/LABA does not appear to have compromised population-level asthma outcomes, perhaps due to better adherence in NZ. Different ICS/LABA subsidy criteria and different patient copayments may also have contributed to these findings.


antiasthmatic agents/therapeutic use; asthma; asthma/epidemiology; asthma/therapy; cross-sectional studies

Comment in

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center