Inhaled anti-inflammatory pharmacotherapy and subsequent hospitalizations and emergency department visits among patients with asthma in the Texas Medicaid program.
BACKGROUND
Rates of asthma-related hospitalizations and emergency department (ED) visits continue to rise in the United States. The National Asthma Education and Prevention Program recommends the use of controller pharmacotherapy for patients with persistent asthma.


OBJECTIVE
To investigate the influence of initiating inhaled anti-inflammatory (IAI) pharmacotherapy following an asthma-related hospitalization or ED visit on risk of subsequent morbid events.


METHODS
Texas Medicaid asthma-related medication and medical services claims for September 1997 to July 2001 were extracted. An asthma-related morbid event served as the index event (ED visit or hospitalization for cohort 1; hospitalization for cohort 2). Members of both cohorts were then followed up until a subsequent morbid event occurred or until 1 year after index. Logistic regression was used to compare patients who used IAI medication within 100 days following their index event with nonusers.


RESULTS
Controlling for demographic and resource use variables, there was a 52% reduction in the risk of a subsequent ED visit or hospitalization in the year following the index event among users of IAI medication within cohort 1 (risk ratio [RR], 0.485; 95% confidence interval [CI], 0.416-0.565; P < .001). There was a 61% reduction in the risk of a subsequent hospitalization among users of IAI medication within cohort 2 (RR, 0.393; 95% CI, 0.284-0.545; P < .001).


CONCLUSIONS
Less than half of the patients had a prescription claim for an IAI medication within 100 days following their index event. Patients who received these medications had a lower risk of a subsequent asthma-related morbid event for the next year.
Smith
Michael James
MJ
West Virginia University, School of Pharmacy, Morgantown, West Virginia 26506-9510, USA. msmith2@hsc.wvu.edu
Rascati
Karen L
KL
McWilliams
Bennie Coleman
BC
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D012720:Severity of Illness Index; D013781:Texas; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents