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The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA.
BMC Pulm Med. 2017 Apr 27; 17(1):74.BP

Abstract

BACKGROUND

Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK.

METHODS

Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model.

RESULTS

Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids.

CONCLUSION

Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management.

Authors+Show Affiliations

Worldwide Epidemiology, GSK, Research Triangle Park, Durham, NC, USA. Present Address: UCB Biosciences, Epidemiology, Research Triangle Park, Durham, NC, USA.Value Outcomes and Epidemiology, PAREXEL International, Research Triangle Park, Durham, NC, USA. Present Address: Department of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.Worldwide Epidemiology, GSK, Stockley Park, Uxbridge, UK. Present Address: Chiltern International Ltd, Slough, Berkshire, UK.Respiratory Medical Franchise, GSK, Research Triangle Park, 5 Moore Drive, PO Box 13398, Durham, NC, 27709, USA. frank.c.albers@gsk.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28449686

Citation

Suruki, Robert Y., et al. "The Frequency of Asthma Exacerbations and Healthcare Utilization in Patients With Asthma From the UK and USA." BMC Pulmonary Medicine, vol. 17, no. 1, 2017, p. 74.
Suruki RY, Daugherty JB, Boudiaf N, et al. The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA. BMC Pulm Med. 2017;17(1):74.
Suruki, R. Y., Daugherty, J. B., Boudiaf, N., & Albers, F. C. (2017). The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA. BMC Pulmonary Medicine, 17(1), 74. https://doi.org/10.1186/s12890-017-0409-3
Suruki RY, et al. The Frequency of Asthma Exacerbations and Healthcare Utilization in Patients With Asthma From the UK and USA. BMC Pulm Med. 2017 Apr 27;17(1):74. PubMed PMID: 28449686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA. AU - Suruki,Robert Y, AU - Daugherty,Jonas B, AU - Boudiaf,Nada, AU - Albers,Frank C, Y1 - 2017/04/27/ PY - 2016/07/22/received PY - 2017/04/11/accepted PY - 2017/4/29/entrez PY - 2017/4/30/pubmed PY - 2018/3/13/medline KW - Claims database KW - Electronic medical records KW - Exacerbation KW - Healthcare utilization KW - Severe eosinophilic asthma KW - Severe uncontrolled asthma SP - 74 EP - 74 JF - BMC pulmonary medicine JO - BMC Pulm Med VL - 17 IS - 1 N2 - BACKGROUND: Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. METHODS: Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model. RESULTS: Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids. CONCLUSION: Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management. SN - 1471-2466 UR - https://www.unboundmedicine.com/medline/citation/28449686/The_frequency_of_asthma_exacerbations_and_healthcare_utilization_in_patients_with_asthma_from_the_UK_and_USA_ L2 - https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0409-3 DB - PRIME DP - Unbound Medicine ER -