title: The relationship between the quality of prescribing and practice appointment rates with asthma management data in those admitted to hospital due to an acute exacerbation.
abstract: Specific targeting of patients with a previous asthma hospitalisation could be more focused if predictors could be identified. This study was an observational retrospective analysis using ridge and linear multivariate regression analysis. Patient asthma management data were extracted from the hospital and general practice notes of those that had been admitted with an acute exacerbation of their asthma over a 5-year period. From the prescribing data, the annual doses of preventer (P) and reliever (R) medication were converted to defined daily doses then divided to give a P:R ratio. Preliminary statistical analysis was used to identify any association between either the P:R ratio or for the number of general practitioner (GP) practice appointments (PA) and their asthma management data. Multivariate regression analysis was applied to the P:R ratio and to PA to determine a model between each of these and asthma management data/events. GPs gave consent to access the data of 115 (out of 440) asthmatics, age >5 years, admitted to a district general hospital for asthma exacerbations between 1994 and 1998. The multivariate analysis revealed that PA was associated with oral prednisolone rescue courses (PRCs) and age whilst the P:R ratio was associated to PRCs and more reliever usage but not preventers. Patients with low preventer usage with respect to their reliever medication should be targeted for medication review as these were the patients prescribed more prednisolone courses and their increased PAs reflect this. This could decrease visits to the doctor and acute exacerbations.
authors.affiliation: School of Pharmacy, Shaheed Beheshti University of Medical Sciences, P.O. Box 14155-6153, Tehran, Iran.
authors.forename: J
authors.initials: J
authors.lastname: Salamzadeh
authors.forename: I C K
authors.initials: IC
authors.lastname: Wong
authors.forename: H S R
authors.initials: HS
authors.lastname: Hosker
authors.forename: M G
authors.initials: MG
authors.lastname: Patel
authors.forename: H
authors.initials: H
authors.lastname: Chrystyn
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy / Q000628:therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D011239:Prednisolone