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A Longitudinal Examination of the Asthma Medication Ratio in Children with Medicaid

Annie Lintzenich Andrews1, Daniel L Brinton2, Kit N Simpson2

  • 1Department of Pediatrics, College of Medicine, Medical, University of South Carolina, Charleston, SC, USA.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|July 18, 2019
PubMed

Insights

The asthma medication ratio (AMR) effectively identifies children with asthma at high risk for exacerbations. This tool can predict severe asthma attacks in children, improving risk assessment and intervention strategies.

Area of Science:

  • Pediatric Pulmonology
  • Health Services Research

Background:

  • Asthma exacerbations in children pose a significant health burden.
  • An efficient risk assessment tool for pediatric asthma exacerbations is needed.
  • The asthma medication ratio (AMR) shows potential as a real-time risk indicator.

Purpose of the Study:

  • To evaluate the asthma medication ratio (AMR) as a predictor of severe asthma exacerbations in Medicaid-enrolled children.
  • To examine the longitudinal performance of AMR in a large pediatric asthma cohort.

Main Methods:

  • Retrospective analysis of 2013-2014 Medicaid pharmacy and medical claims data.
  • Inclusion of children aged 2-17 years with at least one inhaled corticosteroid claim.
  • Calculation of AMR for rolling 3-month periods and logistic regression analysis to predict severe exacerbations.

Main Results:

  • A cohort of 214,452 children with asthma was analyzed.
  • 8-9% of children exhibited a high-risk AMR ( < 0.5) in any given period.
  • High-risk AMR was associated with significantly increased odds of subsequent severe exacerbations (OR 1.7-1.9).

Conclusions:

  • The asthma medication ratio (AMR) is a reliable predictor of severe asthma exacerbations in children.
  • AMR can inform the development of risk assessment and communication interventions for pediatric asthma.
  • This study supports the use of AMR for proactive management of childhood asthma.

Keywords:
Control/managementpediatricspreventiontreatment

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