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High use of health services in patients with suboptimal asthma drug regimens: a population-based assessment in British Columbia, Canada.
Pharmacoepidemiol Drug Saf. 2013 Jul; 22(7):744-51.PD

Abstract

BACKGROUND

Despite numerous clinical guidelines on asthma management, patients often receive suboptimal drug therapy. This study identified patients who received suboptimal regimens according to the National Heart, Lung and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma in a complete population (residents of British Columbia, Canada) and determined the association between patients' regimens and utilization of healthcare services.

METHODS

A total of 65,345 asthma patients were identified using provincial health service utilization data (including all respiratory-related prescription medication dispensings, physician and hospital visits) for the 2009 fiscal year. Patient-specific regimens of inhaled short-acting bronchodilators (SABA) with or without inhaled corticosteroids (ICS) were categorized as optimal or suboptimal. Logistic regression models were used to determine the association between regimen optimality and health service utilization, adjusted for socioeconomic status, prior year hospital and emergency department (ED) visits for asthma.

RESULTS

Patients with suboptimal regimens had significantly greater risk of using health services than patients with optimal regimens of SABA and/or ICS. In particular, adolescents with suboptimal regimens were the most likely to have hospital admissions (odds ratio (OR) 3.8; 95% confidence interval (CI) 1.8-7.8), visit the ED (OR 2.2; 95% CI 1.6-3.1) and be high users of family physician services (OR 5.7; 95% CI 4.0-8.1) compared with patients in other age groups.

CONCLUSIONS

Suboptimal regimens are associated with significantly high usage of health services. Identifying patients with suboptimal regimens and improving their medication management in accordance with asthma clinical guidelines are likely to result in lower health service utilization.

Authors+Show Affiliations

Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23559540

Citation

Zhang, Tingting, et al. "High Use of Health Services in Patients With Suboptimal Asthma Drug Regimens: a Population-based Assessment in British Columbia, Canada." Pharmacoepidemiology and Drug Safety, vol. 22, no. 7, 2013, pp. 744-51.
Zhang T, Smith MA, Camp PG, et al. High use of health services in patients with suboptimal asthma drug regimens: a population-based assessment in British Columbia, Canada. Pharmacoepidemiol Drug Saf. 2013;22(7):744-51.
Zhang, T., Smith, M. A., Camp, P. G., & Carleton, B. C. (2013). High use of health services in patients with suboptimal asthma drug regimens: a population-based assessment in British Columbia, Canada. Pharmacoepidemiology and Drug Safety, 22(7), 744-51. https://doi.org/10.1002/pds.3444
Zhang T, et al. High Use of Health Services in Patients With Suboptimal Asthma Drug Regimens: a Population-based Assessment in British Columbia, Canada. Pharmacoepidemiol Drug Saf. 2013;22(7):744-51. PubMed PMID: 23559540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High use of health services in patients with suboptimal asthma drug regimens: a population-based assessment in British Columbia, Canada. AU - Zhang,Tingting, AU - Smith,M Anne, AU - Camp,Pat G, AU - Carleton,Bruce C, Y1 - 2013/04/05/ PY - 2012/06/13/received PY - 2013/02/15/revised PY - 2013/03/06/accepted PY - 2013/4/6/entrez PY - 2013/4/6/pubmed PY - 2014/2/5/medline KW - asthma KW - health service utilization KW - pharmacoepidemiology KW - suboptimal drug regimens SP - 744 EP - 51 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 22 IS - 7 N2 - BACKGROUND: Despite numerous clinical guidelines on asthma management, patients often receive suboptimal drug therapy. This study identified patients who received suboptimal regimens according to the National Heart, Lung and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma in a complete population (residents of British Columbia, Canada) and determined the association between patients' regimens and utilization of healthcare services. METHODS: A total of 65,345 asthma patients were identified using provincial health service utilization data (including all respiratory-related prescription medication dispensings, physician and hospital visits) for the 2009 fiscal year. Patient-specific regimens of inhaled short-acting bronchodilators (SABA) with or without inhaled corticosteroids (ICS) were categorized as optimal or suboptimal. Logistic regression models were used to determine the association between regimen optimality and health service utilization, adjusted for socioeconomic status, prior year hospital and emergency department (ED) visits for asthma. RESULTS: Patients with suboptimal regimens had significantly greater risk of using health services than patients with optimal regimens of SABA and/or ICS. In particular, adolescents with suboptimal regimens were the most likely to have hospital admissions (odds ratio (OR) 3.8; 95% confidence interval (CI) 1.8-7.8), visit the ED (OR 2.2; 95% CI 1.6-3.1) and be high users of family physician services (OR 5.7; 95% CI 4.0-8.1) compared with patients in other age groups. CONCLUSIONS: Suboptimal regimens are associated with significantly high usage of health services. Identifying patients with suboptimal regimens and improving their medication management in accordance with asthma clinical guidelines are likely to result in lower health service utilization. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/23559540/High_use_of_health_services_in_patients_with_suboptimal_asthma_drug_regimens:_a_population_based_assessment_in_British_Columbia_Canada_ L2 - https://doi.org/10.1002/pds.3444 DB - PRIME DP - Unbound Medicine ER -