Uncontrolled asthma events among Massachusetts patients declined between 2002 and 2007

Research Activities, December 2010, No. 364

Chronic asthma in the United States is estimated to affect upwards of 20 million individuals. Uncontrolled asthma can lead to breathing crises that may result in emergency department (ED) visits or hospitalizations. The good news is that the percentage of Massachusetts patients experiencing such events declined from 39 percent to 27 percent over a 5-year period, according to a new study. The researchers based their finding on their analysis of administrative data from 2002 to 2007 for patient members of a large health plan in that State.

Uncontrolled asthma events were considered to have occurred if the patient used one of the following four types of care: (1) asthma-related hospitalizations, (2) asthma-related ED visits, (3) two or more systemic oral corticosteroid prescription fills within a 12-month period, and (4) five or more short-acting beta-agonist (SABA) prescription fills within a 12-month period. Inhaled (as opposed to oral) corticosteroids, so-called "controller" medications, prevent and reduce lung inflammation that can lead to asthma flares.

In this study, the largest decline in uncontrolled asthma events occurred in the group receiving five or more SABA prescription fills, which dropped from 32 percent in 2002-2003 to 19 percent in 2006-2007. The next largest decrease occurred in the group of patients receiving oral steroid fills (from 16 percent in 2003-2003 to 12 percent in 2006-2007). The authors suggest that one possible reason for the decline in use of SABAs may be the increased use of controller medications that would reduce the need for them.

Individuals at highest risk of more intensive SABA use were adult males in neighborhoods with lower educational attainment. Children were more likely than adults to have several oral steroid prescriptions. This study was supported by the Agency for Healthcare Research and Quality (HS10391).

See "Uncontrolled asthma in a commercially insured population from 2002 to 2007: Trends, predictors, and costs," by Gregory S. Sawicki, M.D., M.P.H., Yury Vilk, Ph.D., Michael Schatz, M.D., M.S., and others in the Journal of Asthma 47, pp. 574-580, 2010.

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