BACKGROUND: The objective of the present analysis was to evaluate treatment patterns and persistence with treatment of an unselected patient population with a diagnosis of asthma. METHODS: The database of the Bavarian statutory health insurance physician's association (Kassenärztliche Vereinigung) covering 83% of the population was analyzed for an index period from April 2005 to March 2006. Defined daily doses (DDDs) were used to quantify treatment persistence. Results were compared with recent guidelines. RESULTS: The prevalence of physician diagnosed asthma in Bavaria was 4.8% in females and 4.5% in males; only 61.4% of these patients (of a total of n = 483,051) received any anti-asthmatic pharmacotherapy; 68.3% received medical care from their general practitioner, and 8.3% from a pulmonologist alone. Most patients (65.1%) received no more than 90 DDDs of controller medication in the index period of 365 days, only about 1% received medication for the complete index period. Long- (40.1%) and short-acting beta(2)-agonists (65.6%) were used more frequently than inhaled corticosteroids (ICS). 52.8% of asthma patients were treated in accordance with guidelines. CONCLUSIONS: Persistence of asthma patients with medical treatment is low, especially for controller medication. The discrepancy between current knowledge, guidelines and clinical practice is substantial and may question the value of current guidelines for the treatment of patients with asthma in ambulatory care. In addition, the results of this study cast doubt on the impact of contemporary treatment on the decline of asthma mortality seen in recent years in Germany.
BACKGROUND: The objective of the present analysis was to evaluate treatment patterns and persistence with treatment of an unselected patient population with a diagnosis of asthma. METHODS: The database of the Bavarian statutory health insurance physician's association (Kassenärztliche Vereinigung) covering 83% of the population was analyzed for an index period from April 2005 to March 2006. Defined daily doses (DDDs) were used to quantify treatment persistence. Results were compared with recent guidelines. RESULTS: The prevalence of physician diagnosed asthma in Bavaria was 4.8% in females and 4.5% in males; only 61.4% of these patients (of a total of n = 483,051) received any anti-asthmatic pharmacotherapy; 68.3% received medical care from their general practitioner, and 8.3% from a pulmonologist alone. Most patients (65.1%) received no more than 90 DDDs of controller medication in the index period of 365 days, only about 1% received medication for the complete index period. Long- (40.1%) and short-acting beta(2)-agonists (65.6%) were used more frequently than inhaled corticosteroids (ICS). 52.8% of asthmapatients were treated in accordance with guidelines. CONCLUSIONS: Persistence of asthmapatients with medical treatment is low, especially for controller medication. The discrepancy between current knowledge, guidelines and clinical practice is substantial and may question the value of current guidelines for the treatment of patients with asthma in ambulatory care. In addition, the results of this study cast doubt on the impact of contemporary treatment on the decline of asthma mortality seen in recent years in Germany.
Authors: Marietta Rottenkolber; Eef Voogd; Liset van Dijk; Paola Primatesta; Claudia Becker; Raymond Schlienger; Mark C H de Groot; Yolanda Alvarez; Julie Durand; Jim Slattery; Ana Afonso; Gema Requena; Miguel Gil; Arturo Alvarez; Ulrik Hesse; Roman Gerlach; Joerg Hasford; Rainald Fischer; Olaf H Klungel; Sven Schmiedl Journal: PLoS One Date: 2015-02-23 Impact factor: 3.240
Authors: Christian Jacob; Benno Bechtel; Susanne Engel; Peter Kardos; Roland Linder; Sebastian Braun; Wolfgang Greiner Journal: Eur J Health Econ Date: 2015-02-26
Authors: S Heck; S Al-Shobash; D Rapp; D D Le; A Omlor; A Bekhit; M Flaig; B Al-Kadah; W Herian; R Bals; S Wagenpfeil; Q T Dinh Journal: NPJ Prim Care Respir Med Date: 2017-04-21 Impact factor: 2.871