Use of ICS/LABA on Asthma Exacerbation Risk in Patients Within a Medical Group
| Autor: | Richard D. O'Connor, Saurabh P Nagar, Richard H. Stanford, Xiwu Lin |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Pharmaceutical Science Pharmacy Insurance Claim Review Young Adult Adrenal Cortex Hormones Internal medicine Administration Inhalation medicine Humans In patient Anti-Asthmatic Agents Retrospective Studies Asthma Asthma exacerbations business.industry Health Policy Adrenergic beta-Agonists Middle Aged Asthma medication medicine.disease United States Delayed-Action Preparations Baseline characteristics Ics laba Physical therapy Female Observational study business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Journal of Managed Care & Specialty Pharmacy. 21:1014-1019 |
| ISSN: | 2376-1032 2376-0540 |
| DOI: | 10.18553/jmcp.2015.21.11.1014 |
| Popis: | Asthma medication ratio (AMR) ≥ 0.5 has been shown to predict asthma exacerbations. This study explores the impact of increasing or decreasing inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) use over a 7-year period on achieving an AMR of ≥ 0.5.To (a) assess the impact of increasing use of ICS/LABAs on changes in a modified AMR (mAMR) and (b) examine asthma risk over time as measured by an mAMR over a 7-year period, adjusting for differences in baseline characteristics.This is a retrospective, observational study using pharmacy and medical claims from a medical group from January 1, 2003, to December 31, 2010. All patients with ≥ 1 asthma diagnosis (ICD-9-CM, 493.xx) with ≥ 1 inhaled asthma medication dispensed in each year of eligibility were included. The mAMR = total ICS controllers dispensed/(total ICS controllers dispensed + albuterol dispensed). The proportion of ICS/LABA use was determined as the number of ICS/LABA canisters dispensed/(total of ICS/LABA + ICS dispensed). Generalized linear mixed models were used to assess the effect of incremental change in ICS/LABA use on mAMR over 7 years, adjusting for differences in resource utilization, time, and asthma medication use. Nine hundred ninety patients (mean age [± SD] 34.7 years [± 18.2], 61.7% female) met all criteria. Overall, mean mAMR increased over time, while mean albuterol use decreased over time. Adjusting for covariates, we found that a 10% increase in ICS/LABA use was associated with a 9% increase (adjusted OR = 1.09, 95% CI = 1.06-1.12) in the likelihood of achieving an mAMR ≥ 0.5, while a 50% increase in ICS/LABA use was associated with a 53% increase (OR = 1.53, 95% CI = 1.31-1.80) in the likelihood of achieving an mAMR ≥ 0.5.Increase in ICS/LABA use over time in a population of asthma patients was significantly associated with a higher likelihood of achieving an mAMR ≥ 0.5. |
| Databáze: | OpenAIRE |
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