People with asthma and a history of illicit drug use are almost four times as likely to require intensive care for an exacerbation, research shows.

Of 482 asthma patients admitted consecutively to Melbourne hospitals between 2010 and 2014, 39 required intensive care.

Ten of these patients (26%) used illicit drugs compared with 29 (7%) of those admitted to the ward (adjusted odds ratio: 3.6, P= 0.012).

For illicit users, non-adherence to preventer therapy was associated with an even higher risk of intensive care unit admission, reported the researchers led by Fiona Moghaddas, Inflammation Division, Walter and Eliza Hall Institute of Medical Research, Melbourne.

“These findings suggest that elucidating an illicit drug history is of immediate clinical relevance in patients presenting with an exacerbation of asthma and should be systematically elicited,” the study authors wrote in their paper published in Respirology.

 “Although there are barriers to this such as time constraints, revelation of substance use provides clinicians with an opportunity to engage with the patients in a discussion about their use and assess their openness to a referral to a drug and alcohol service,” they added.