STUDY OBJECTIVES: To assess trends in asthma management and to identify factors associated with increasing short-acting (SA) beta-agonist utilization in British Columbia using administrative prescription data. DESIGN: A retrospective cohort analysis. SETTING: All patients between 13 and 50 years of age who had received at least one prescription for a SA beta-agonist covered by BC Pharmacare between January 1, 1996, and December 31, 1998. METHODS: Cross-sectional analysis of all patients, and longitudinal analyses only of patients who had received at least one SA beta-agonist prescription in each of the 3 years. Trends in asthma medication use over time were evaluated using repeated-measures Mantel-Haenszel tests. Multiple logistic regression was used to identify factors associated with increasing SA beta-agonist use. RESULTS: A total of 78,758 patients were included in the cohort. No decrease in the annual prevalence of receiving more than four canisters per year of a SA beta-agonist was identified between 1996 and 1998. A total of 12,844 patients filled at least one SA beta-agonist prescription each year. Time-trend analysis showed an overall increasing probability of not receiving an inhaled corticosteroid (ICS) agent in this population (p = 0.002). In patients exhibiting low SA beta-agonist use, > 18 years of age (adjusted odds ratio [OR], 1.5), male gender (adjusted OR, 1.7), and in receipt of social assistance (adjusted OR, 2.3) were associated with receiving increasing amounts of SA beta-agonist agents over the 3 years. In patients with a high degree of use of SA beta-agonists, only the receipt of social assistance (adjusted OR, 1.3) was significantly associated with increasing use. CONCLUSIONS: Despite the development and dissemination of asthma management guidelines, there was no trend toward decreasing SA beta-agonist use. An unexpected trend toward decreasing ICS utilization was identified. Receiving social assistance was a risk factor for increasing SA beta-agonist use, independent of baseline utilization.
STUDY OBJECTIVES: To assess trends in asthma management and to identify factors associated with increasing short-acting (SA) beta-agonist utilization in British Columbia using administrative prescription data. DESIGN: A retrospective cohort analysis. SETTING: All patients between 13 and 50 years of age who had received at least one prescription for a SA beta-agonist covered by BC Pharmacare between January 1, 1996, and December 31, 1998. METHODS: Cross-sectional analysis of all patients, and longitudinal analyses only of patients who had received at least one SA beta-agonist prescription in each of the 3 years. Trends in asthma medication use over time were evaluated using repeated-measures Mantel-Haenszel tests. Multiple logistic regression was used to identify factors associated with increasing SA beta-agonist use. RESULTS: A total of 78,758 patients were included in the cohort. No decrease in the annual prevalence of receiving more than four canisters per year of a SA beta-agonist was identified between 1996 and 1998. A total of 12,844 patients filled at least one SA beta-agonist prescription each year. Time-trend analysis showed an overall increasing probability of not receiving an inhaled corticosteroid (ICS) agent in this population (p = 0.002). In patients exhibiting low SA beta-agonist use, > 18 years of age (adjusted odds ratio [OR], 1.5), male gender (adjusted OR, 1.7), and in receipt of social assistance (adjusted OR, 2.3) were associated with receiving increasing amounts of SA beta-agonist agents over the 3 years. In patients with a high degree of use of SA beta-agonists, only the receipt of social assistance (adjusted OR, 1.3) was significantly associated with increasing use. CONCLUSIONS: Despite the development and dissemination of asthma management guidelines, there was no trend toward decreasing SA beta-agonist use. An unexpected trend toward decreasing ICS utilization was identified. Receiving social assistance was a risk factor for increasing SA beta-agonist use, independent of baseline utilization.
Authors: Mohsen Sadatsafavi; Larry Lynd; Carlo Marra; Bruce Carleton; Wan C Tan; Sean Sullivan; J Mark Fitzgerald Journal: Can Respir J Date: 2010 Mar-Apr Impact factor: 2.409
Authors: Helen M McTaggart-Cowan; Carlo A Marra; Yaling Yang; John E Brazier; Jacek A Kopec; J Mark FitzGerald; Aslam H Anis; Larry D Lynd Journal: Qual Life Res Date: 2008-02-15 Impact factor: 4.147
Authors: Teresa To; Jun Guan; Jingqin Zhu; M Diane Lougheed; Alan Kaplan; Itamar Tamari; Matthew B Stanbrook; Jacqueline Simatovic; Laura Feldman; Andrea S Gershon Journal: BMC Fam Pract Date: 2015-02-14 Impact factor: 2.497