Chest
Clinical InvestigationsASTHMATreatment Patterns in the Months Prior to and After Asthma-Related Emergency Department Visit
Section snippets
Materials and Methods
This study is a descriptive retrospective analysis focusing on the 12 months prior to and the 2 months following an initial asthma-related ED visit. During this time period, patient demographics, comorbid conditions, asthma-related medical claims (eg, medications, office visits, and spirometry procedures for patients ≥ 6 years of age), and office visits associated with other diagnoses were collected by month. The number of claims for asthma medications dispensed was calculated as well as the
Results
There were 12,636 patients identified with an asthma-related ED visit. Hospitalizations were reported in 10.5% of these patients. Children aged 0 to 17 years comprised 43.5% of the total number of subjects. The mean age of patients in the released cohort was 25.8 years. Patients who were subsequently hospitalized were slightly older, with a mean age of 31.0 years. Women comprised 58.8% of the total cohort. During the observation period, comorbid acute upper respiratory infections were reported
Discussion
This analysis demonstrates the greater dependence for this population on rescue medications including SABAs and OCSs. OCSs were dispensed to 30% of the patients in the year prior to an asthma-related ED event and to 39% of patients in the 12 months prior to a hospitalization. The mean number of rescue medications was consistent over the 12 months prior to the event and did not appear to be dispensed as an intervention to prevent the index ED event. Although pharmacy claims do not indicate
References (17)
- et al.
Decrease in hospitalizations for treatment of childhood asthma with increased use of anti-inflammatory treatment, despite an increase in the prevalence of asthma
J Allergy Clin Immunol
(1996) - et al.
Inhaled corticosteroids and allergy specialty care reduce emergency hospital use for asthma
J Allergy Clin Immunol
(2003) - et al.
Inadequate use of asthma medication in the United States: results of the asthma in America national population survey
J Allergy Clin Immunol
(2002) - et al.
START Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial
Lancet
(2003) - National Asthma Education and Prevention Program. Expert panel report 2: guidelines for the diagnosis and management of...
Expert panel report: guidelines for the diagnosis and management of asthma update on selected topics-2002
J Allergy Clin Immunol
(2002)National Institutes of Health and National Hearty, Lung and Blood Institute, revised
- et al.
Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and and or chronic asthma in adults and children
Cochrane Database Syst Rev
(2002)
Cited by (47)
Pharmacological approaches to target type 2 cytokines in asthma
2022, Pharmacology and TherapeuticsAcute and chronic systemic corticosteroid-related complications in patients with severe asthma
2015, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Moreover, to take into account the fact that cumulative SCS exposure can change over time and that confounders can vary over time, patients' follow-up periods were split into quarters. Quarters were chosen because they were previously found to be short enough to be sensitive to changes in SCS dosing but long enough to enable observation of variations in time-dependent variables and outcomes.22,28 This study was subject to some limitations.
Perceived 10-year change in respiratory health: Reliability and predictive ability
2015, Respiratory MedicineRandomized controlled trials and real life studies. Approaches and methodologies: A clinical point of view.
2014, Pulmonary Pharmacology and TherapeuticsAdherence. The Goal to Control Asthma
2012, Clinics in Chest MedicineCitation Excerpt :When Krishnan and colleagues27 followed up 60 patients hospitalized for an exacerbation of asthma, they found that use of controllers and oral corticosteroids decreased to 50% of the prescribed dose at 7 days after hospital discharge and that poor adherence was significantly associated with worse asthma control. The link between poor adherence and worse asthma control is further supported by an epidemiologic study of administrative claims from more than 20 managed care plans located throughout the United States.28 Of 12,636 patients who had used the emergency department for acute asthma, 75% had not received ICS in the year preceding the event, and in those for whom ICS was prescribed, the average supply was 3 canisters per year, representing about half of the minimum required.
Asthma: Treatment of exacerbations
2012, Revue des Maladies Respiratoires
This study was supported by GlaxoSmithKline, Research Triangle Park, NC.
Dr. Stempel is a consultant for GlaxoSmithKline, Dr. Roberts was an employee of NDCHealth at the time of article submission, and Dr. Stanford is an employee of GlaxoSmithKline.