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Relationship between asthma drug therapy patterns and healthcare utilization
Theresa I Shireman1, Pamela C Heaton, Wendy E Gay
1Pharmacy Practice Department, School of Pharmacy, University of Kansas, Lawrence, KS 66045-7582, USA. tshireman@rx.pharm.ukans.edu
The Annals of Pharmacotherapy
|March 29, 2002
Summary
Inappropriate asthma drug therapy and patient demographics are linked to increased healthcare use. Many patients do not follow national asthma guidelines, indicating a need for improved medication management.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Pharmacoeconomics
Background:
- Asthma drug therapy problems contribute to preventable hospitalizations and increased healthcare utilization.
- Concurrent asthma drug therapies may predict excessive healthcare use, especially in patients requiring multiple medications.
Purpose of the Study:
- To link inappropriate asthma drug therapy patterns and patient demographics to healthcare utilization.
- To identify specific drug therapy problems and demographic factors associated with increased healthcare use in asthma patients.
Main Methods:
- Retrospective, cross-sectional analysis of Ohio Medicaid claims data (April 1998-March 1999).
- Included ambulatory patients aged 15-65 with >=2 asthma claims, continuously enrolled.
- Examined demographics, gastroesophageal reflux disease, and usage patterns of inhaled corticosteroids, beta-agonists, theophylline, and leukotriene modifiers.
Main Results:
- Only 46.8% of patients used >1 puff of inhaled corticosteroid daily; 44% used >3 puffs of short-acting beta(2)-agonists daily.
- Oral steroid bursts were most common (46.5%). High short-acting beta(2)-agonist use correlated with increased steroid bursts and hospitalizations.
- African Americans and women had higher odds of adverse outcomes; leukotriene receptor modifier use was linked to increased outcomes.
Conclusions:
- A significant percentage of Ohio Medicaid asthma patients did not adhere to National Heart, Lung, and Blood Institute guidelines.
- Asthma drug therapy patterns show room for improvement and remain associated with excess healthcare utilization.