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Clinical outcomes of levalbuterol versus racemic albuterol in pediatric patients with asthma: Propensity score matching approach in a medicaid population.
Pediatr Pulmonol. 2017 04; 52(4):516-523.PP

Abstract

OBJECTIVE

Racemic albuterol and levalbuterol are used to treat acute episodes of asthma. The main objective of this study was to compare levalbuterol therapy to albuterol therapy on incidence rates of subsequent emergency department (ED) visits and hospitalizations.

METHOD

We conducted a retrospective cohort study of asthmatic children who had pharmacy refills for levalbuterol/albuterol in the South Carolina Medicaid database in 2002-2011. Children receiving levalbuterol were matched to those receiving albuterol using propensity score matching technique. For ED visits and separately for hospitalizations, multivariable negative binomial regression was used to estimate the two group-specific incidence rates and the incidence rate ratio (IRR).

RESULTS

A total of 8,172 asthmatic patients aged 2-18 years were identified in the South Carolina Medicaid database. During the 12-month follow-up period, the levalbuterol group had fewer asthma-related ED visits and hospitalizations: 939 (11.49%) children had asthma-related ED visits (levalbuterol: 8.76%; albuterol: 14.21%), and 89 (1.09%) children had asthma-related hospitalizations (levalbuterol: 1.07%; albuterol: 1.12%). Comparing the levalbuterol group to the albuterol group, the adjusted IRR estimate was 0.57 (95% confidence interval [CI], 0.49-0.65) for of asthma-related ED visits, and 0.93 (95%CI, 0.99-1.63) for hospitalizations. Children filling levalbuterol also had a lower IRR of all-cause ED visit (0.88; 95%CI, 0.82-0.95), but similar IRR of all-cause hospitalizations (1.08; 95%CI, 0.82-1.42).

CONCLUSION

This observational study of children aged 2-18 demonstrated levalbuterol prescription fills were associated with reduced ED visits, but not hospitalizations. Additional research may be necessary to assess this association. Pediatr Pulmonol. 2017;52:516-523. © 2016 Wiley Periodicals, Inc.

Authors+Show Affiliations

Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, 715 Sumter Street, CLS Building Room 311G, Columbia, South Carolina, 29208.Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, 715 Sumter Street, CLS Building Room 311G, Columbia, South Carolina, 29208.University of Cincinnati College of Pharmacy, Cincinnati, Ohio.Presbyterian College School of Pharmacy, Clinton, South Carolina.Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, 715 Sumter Street, CLS Building Room 311G, Columbia, South Carolina, 29208.Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, 715 Sumter Street, CLS Building Room 311G, Columbia, South Carolina, 29208.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27701831

Citation

Yuan, Jing, et al. "Clinical Outcomes of Levalbuterol Versus Racemic Albuterol in Pediatric Patients With Asthma: Propensity Score Matching Approach in a Medicaid Population." Pediatric Pulmonology, vol. 52, no. 4, 2017, pp. 516-523.
Yuan J, Lu ZK, Zhang Y, et al. Clinical outcomes of levalbuterol versus racemic albuterol in pediatric patients with asthma: Propensity score matching approach in a medicaid population. Pediatr Pulmonol. 2017;52(4):516-523.
Yuan, J., Lu, Z. K., Zhang, Y., Wu, J., Love, B. L., & Schulz, R. M. (2017). Clinical outcomes of levalbuterol versus racemic albuterol in pediatric patients with asthma: Propensity score matching approach in a medicaid population. Pediatric Pulmonology, 52(4), 516-523. https://doi.org/10.1002/ppul.23565
Yuan J, et al. Clinical Outcomes of Levalbuterol Versus Racemic Albuterol in Pediatric Patients With Asthma: Propensity Score Matching Approach in a Medicaid Population. Pediatr Pulmonol. 2017;52(4):516-523. PubMed PMID: 27701831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical outcomes of levalbuterol versus racemic albuterol in pediatric patients with asthma: Propensity score matching approach in a medicaid population. AU - Yuan,Jing, AU - Lu,Zhiqiang Kevin, AU - Zhang,Yanjun, AU - Wu,Jun, AU - Love,Bryan L, AU - Schulz,Richard M, Y1 - 2016/10/04/ PY - 2015/10/23/received PY - 2016/07/22/revised PY - 2016/08/16/accepted PY - 2016/10/5/pubmed PY - 2017/10/11/medline PY - 2016/10/5/entrez KW - Medicaid KW - albuterol KW - asthma KW - levalbuterol KW - pediatric SP - 516 EP - 523 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 52 IS - 4 N2 - OBJECTIVE: Racemic albuterol and levalbuterol are used to treat acute episodes of asthma. The main objective of this study was to compare levalbuterol therapy to albuterol therapy on incidence rates of subsequent emergency department (ED) visits and hospitalizations. METHOD: We conducted a retrospective cohort study of asthmatic children who had pharmacy refills for levalbuterol/albuterol in the South Carolina Medicaid database in 2002-2011. Children receiving levalbuterol were matched to those receiving albuterol using propensity score matching technique. For ED visits and separately for hospitalizations, multivariable negative binomial regression was used to estimate the two group-specific incidence rates and the incidence rate ratio (IRR). RESULTS: A total of 8,172 asthmatic patients aged 2-18 years were identified in the South Carolina Medicaid database. During the 12-month follow-up period, the levalbuterol group had fewer asthma-related ED visits and hospitalizations: 939 (11.49%) children had asthma-related ED visits (levalbuterol: 8.76%; albuterol: 14.21%), and 89 (1.09%) children had asthma-related hospitalizations (levalbuterol: 1.07%; albuterol: 1.12%). Comparing the levalbuterol group to the albuterol group, the adjusted IRR estimate was 0.57 (95% confidence interval [CI], 0.49-0.65) for of asthma-related ED visits, and 0.93 (95%CI, 0.99-1.63) for hospitalizations. Children filling levalbuterol also had a lower IRR of all-cause ED visit (0.88; 95%CI, 0.82-0.95), but similar IRR of all-cause hospitalizations (1.08; 95%CI, 0.82-1.42). CONCLUSION: This observational study of children aged 2-18 demonstrated levalbuterol prescription fills were associated with reduced ED visits, but not hospitalizations. Additional research may be necessary to assess this association. Pediatr Pulmonol. 2017;52:516-523. © 2016 Wiley Periodicals, Inc. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/27701831/Clinical_outcomes_of_levalbuterol_versus_racemic_albuterol_in_pediatric_patients_with_asthma:_Propensity_score_matching_approach_in_a_medicaid_population_ L2 - https://doi.org/10.1002/ppul.23565 DB - PRIME DP - Unbound Medicine ER -