An inverse relationship between asthma prevalence and medication dispensation trend: a 12-year spatial analysis of electronic health record data in Alberta, Canada

Asthma is a chronic inflammatory disease of the airways that affects over 300 million people worldwide [1]. As of 2019, 2.95 million Canadians were diagnosed with asthma [2]. While there are standard recommendations and guidelines for the diagnosis and treatment of asthma, patients living with this disease often experience poor health-related quality of life [3] and continue to experience exacerbations [4]. Apart from the increasing air pollution, rapid urbanization, and a growing trend in marijuana and vaping, particularly among the adolescents [5–8], poor patient adherence to asthma medications is a major contributing factor to these outcomes [9–12]. Despite efforts to change this narrative through patient and physician education [13–15], it is well reported that adherence to treatment in asthma is varied, with rates of <50% in children [16] and 30–70% in adults [1, 17]. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: SM reports personal fees from Synergy Respiratory & Cardiac Care (Canada), Permanyer Inc. (Spain), Elsevier Inc. (USA), Apollo Gleneagles Hospital (India), and Institute of Allergy-Kolkata (India), outside the submitted work. Conflict of interest: AF does not have any conflict of interest to declare. Conflict of interest: MB received grants from Canadian Institute of Health research, Sanofi Genzyme, Astra Zeneca, and GSK; and received payments from Astra Zeneca, GSK, Sanofi Genzyme, Valeo, Covis Pharmaceuticals, and Canadian Thoracic Society, outside the submitted work.