title: Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis.
abstract: OBJECTIVE
  To determine the incremental effect of allergic rhinitis on health care resource use in children with asthma.
  
  
  METHODS
  Population-based historical cohort study.
  
  
  METHODS
  Data in a general practice database in the United Kingdom during 1998 to 2001.
  
  
  METHODS
  Children 6 to 15 years old with asthma and with >or=1 asthma-related visits to a general practitioner (GP) during a 12-month follow-up period.
  
  
  METHODS
  Asthma-related hospitalizations, GP visits, and prescription drug costs during the 12-month follow-up period for patients with and without comorbid allergic rhinitis.
  
  
  RESULTS
  Of 9522 children with asthma, 1879 (19.7%) had allergic rhinitis recorded in the GP medical records. Compared with children with asthma alone, children with comorbid allergic rhinitis experienced more GP visits (4.4 vs 3.4) and more of them were hospitalized for asthma (1.4% vs 0.5%) during the 12-month follow-up period. In multivariable regression analyses, comorbid allergic rhinitis was an independent predictor of hospitalization for asthma (odds ratio: 2.34; 95% confidence interval [CI]: 1.41-3.91) and was associated with increases in the number of asthma-related GP visits (mean increase: 0.53; 95% CI: 0.52-0.54) and asthma drug costs (mean increase pound: 6.7; 95% CI: 6.5-7.0). The association between allergic rhinitis and higher costs of prescriptions for asthma drugs was independent of asthma severity, measured indirectly by the intensity of use of asthma drugs.
  
  
  CONCLUSIONS
  Children with comorbid allergic rhinitis incurred greater prescription drug costs and experienced more GP visits and hospitalizations for asthma than did children with asthma alone. A unified treatment strategy for asthma and allergic rhinitis, as recommended by the Allergic Rhinitis and Its Impact on Asthma initiative, might reduce the costs of treating these conditions.
authors.affiliation: Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
authors.forename: Vasilisa Sazonov
authors.initials: VS
authors.lastname: Kocevar
authors.forename: Qiaoyi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Donald D
authors.initials: DD
authors.lastname: Yin
authors.forename: David
authors.initials: D
authors.lastname: Price
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000150:complications / Q000188:drug therapy; D002648:Child; D015331:Cohort Studies; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011306:Prescription Fees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000150:complications*; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents