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Comparing outcomes in patients with persistent asthma: a registry of two therapeutic alternatives.
Curr Med Res Opin. 2006 Mar; 22(3):453-61.CM

Abstract

OBJECTIVE

Clinical trials have demonstrated improved efficacy of fluticasone propionate/salmeterol (100/50 mcg) in a single device (FSC) compared with montelukast (10 mg) (MON). This study was designed to assess asthma control, asthma-related quality of life, asthma-related emergency department (ED) visit/hospitalization, treatment-related satisfaction, and productivity losses in patients newly started on FSC or MON.

RESEARCH DESIGN AND METHODS

Patients who were newly prescribed FSC or MON during a regularly scheduled office visit were enrolled in a prospective observational study by nearly 500 physicians from eight managed care plans. Patient survey data were collected at baseline and at months 1, 3, 6, and 12, to measure study outcomes. ED visits/inpatient stays were reported from commercial claims data. Multivariate analyses assessed 12-month outcomes, controlling for several baseline patient characteristics.

RESULTS

A total of 1414 patients >or= 15 years old were enrolled in the registry (FSC, n = 1061; MON, n = 353), 90% of which completed a 12-month survey. FSC patients had significantly greater improvement in both asthma control and quality of life, and reported significantly higher satisfaction with their medication (p = 0.003) and fewer days at work/school with asthma symptoms (p = 0.04) than MON. Other parameters of productivity losses such as missed work/school days due to asthma were not significantly different between the two groups. FSC use was also significantly associated with a lower risk of an asthma-related ED visit/hospitalization compared with MON (odds ratio = 0.35, 95% confidence interval: 0.15-0.92).

CONCLUSION

In a 12-month office-based observational study, patients age 15 and older with persistent asthma, newly started on FSC, improved in symptom, quality of life, treatment, and utilization-related outcomes compared with patients newly started on MON. These results should be interpreted in light of the inherent limitations of non-randomized, uncontrolled studies.

Authors+Show Affiliations

University of California at San Diego, San Diego, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16574029

Citation

O'Connor, Richard D., et al. "Comparing Outcomes in Patients With Persistent Asthma: a Registry of Two Therapeutic Alternatives." Current Medical Research and Opinion, vol. 22, no. 3, 2006, pp. 453-61.
O'Connor RD, Gilmore AS, Manjunath R, et al. Comparing outcomes in patients with persistent asthma: a registry of two therapeutic alternatives. Curr Med Res Opin. 2006;22(3):453-61.
O'Connor, R. D., Gilmore, A. S., Manjunath, R., Stanford, R. H., Legorreta, A. P., & Jhingran, P. M. (2006). Comparing outcomes in patients with persistent asthma: a registry of two therapeutic alternatives. Current Medical Research and Opinion, 22(3), 453-61.
O'Connor RD, et al. Comparing Outcomes in Patients With Persistent Asthma: a Registry of Two Therapeutic Alternatives. Curr Med Res Opin. 2006;22(3):453-61. PubMed PMID: 16574029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing outcomes in patients with persistent asthma: a registry of two therapeutic alternatives. AU - O'Connor,Richard D, AU - Gilmore,Amanda S, AU - Manjunath,Ranjani, AU - Stanford,Richard H, AU - Legorreta,Antonio P, AU - Jhingran,Priti M, PY - 2006/4/1/pubmed PY - 2006/8/11/medline PY - 2006/4/1/entrez SP - 453 EP - 61 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 22 IS - 3 N2 - OBJECTIVE: Clinical trials have demonstrated improved efficacy of fluticasone propionate/salmeterol (100/50 mcg) in a single device (FSC) compared with montelukast (10 mg) (MON). This study was designed to assess asthma control, asthma-related quality of life, asthma-related emergency department (ED) visit/hospitalization, treatment-related satisfaction, and productivity losses in patients newly started on FSC or MON. RESEARCH DESIGN AND METHODS: Patients who were newly prescribed FSC or MON during a regularly scheduled office visit were enrolled in a prospective observational study by nearly 500 physicians from eight managed care plans. Patient survey data were collected at baseline and at months 1, 3, 6, and 12, to measure study outcomes. ED visits/inpatient stays were reported from commercial claims data. Multivariate analyses assessed 12-month outcomes, controlling for several baseline patient characteristics. RESULTS: A total of 1414 patients >or= 15 years old were enrolled in the registry (FSC, n = 1061; MON, n = 353), 90% of which completed a 12-month survey. FSC patients had significantly greater improvement in both asthma control and quality of life, and reported significantly higher satisfaction with their medication (p = 0.003) and fewer days at work/school with asthma symptoms (p = 0.04) than MON. Other parameters of productivity losses such as missed work/school days due to asthma were not significantly different between the two groups. FSC use was also significantly associated with a lower risk of an asthma-related ED visit/hospitalization compared with MON (odds ratio = 0.35, 95% confidence interval: 0.15-0.92). CONCLUSION: In a 12-month office-based observational study, patients age 15 and older with persistent asthma, newly started on FSC, improved in symptom, quality of life, treatment, and utilization-related outcomes compared with patients newly started on MON. These results should be interpreted in light of the inherent limitations of non-randomized, uncontrolled studies. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/16574029/Comparing_outcomes_in_patients_with_persistent_asthma:_a_registry_of_two_therapeutic_alternatives_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079906X89793 DB - PRIME DP - Unbound Medicine ER -