OBJECTIVE: To evaluate whether an assessment of subacute lack of asthma control (SALAC) predicts subsequent acute asthma exacerbation (AAE). STUDY DESIGN: This retrospective administrative claims study used medical and pharmacy claims from the HealthCore Integrated Research Database to identify patients aged 6 to 64 years with asthma and having 3 years' continuous enrollment from January 1, 2003, through December 31, 2005. METHODS: Study inclusion criteria were at least 2 outpatient visits or at least 1 hospitalization or emergency department (ED) visit with an asthma diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification code 493.xx) in at least 1 of 3 years (2003-2005). SALAC was defined as more than 4 asthma outpatient visits or more than 5 short-acting beta2-agonist (SABA) prescriptions per year, and AAE was defined as at least 1 hospitalization or ED visit with a primary asthma diagnosis or an oral corticosteroid burst prescription. Generalized estimating equations modeled the risk of subsequent-year AAE as a function of 2 sets of variables to determine the independent effect of prior-year SALAC and its components on subsequent-year AAE. The first set included age, sex, geographic region, prior year AAE, and prior-year SALAC. The second set included age, sex, geographic region, prior-year AAE, high prior-year SABA use, and frequent prior-year asthma outpatient visits. RESULTS: Of 35,806 patients with asthma, 46.6% were male, and 35.8% were younger than 18 years. The mean annual prevalence of SALAC was 12.1%. Controlling for all other variables, the generalized estimating equation results indicate that prior-year SALAC is associated with a 60% increased risk of subsequent-year AAE (P <.001). Increased prior-year asthma outpatient visits and SABA use are associated with 34% and 85%, respectively, greater risks of subsequent-year AAE (P <.001 for both). CONCLUSION: SALAC and its components can aid in predicting patients at risk for AAE.
OBJECTIVE: To evaluate whether an assessment of subacute lack of asthma control (SALAC) predicts subsequent acute asthma exacerbation (AAE). STUDY DESIGN: This retrospective administrative claims study used medical and pharmacy claims from the HealthCore Integrated Research Database to identify patients aged 6 to 64 years with asthma and having 3 years' continuous enrollment from January 1, 2003, through December 31, 2005. METHODS: Study inclusion criteria were at least 2 outpatient visits or at least 1 hospitalization or emergency department (ED) visit with an asthma diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification code 493.xx) in at least 1 of 3 years (2003-2005). SALAC was defined as more than 4 asthma outpatient visits or more than 5 short-acting beta2-agonist (SABA) prescriptions per year, and AAE was defined as at least 1 hospitalization or ED visit with a primary asthma diagnosis or an oral corticosteroid burst prescription. Generalized estimating equations modeled the risk of subsequent-year AAE as a function of 2 sets of variables to determine the independent effect of prior-year SALAC and its components on subsequent-year AAE. The first set included age, sex, geographic region, prior year AAE, and prior-year SALAC. The second set included age, sex, geographic region, prior-year AAE, high prior-year SABA use, and frequent prior-year asthma outpatient visits. RESULTS: Of 35,806 patients with asthma, 46.6% were male, and 35.8% were younger than 18 years. The mean annual prevalence of SALAC was 12.1%. Controlling for all other variables, the generalized estimating equation results indicate that prior-year SALAC is associated with a 60% increased risk of subsequent-year AAE (P <.001). Increased prior-year asthma outpatient visits and SABA use are associated with 34% and 85%, respectively, greater risks of subsequent-year AAE (P <.001 for both). CONCLUSION:SALAC and its components can aid in predicting patients at risk for AAE.
Authors: James A Kaye; Jordi Castellsague; Christine L Bui; Brian Calingaert; Lisa J McQuay; Nuria Riera-Guardia; Catherine W Saltus; Scott Quinlan; Crystal N Holick; Peter M Wahl; Kiliana Suzart; Kenneth J Rothman; Mari-Ann Wallander; Susana Perez-Gutthann Journal: Pharmacotherapy Date: 2013-11-05 Impact factor: 4.705
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Authors: Francisco Javier Álvarez Gutiérrez; Marta Ferrer Galván; Juan Francisco Medina Gallardo; Marta Barrera Mancera; Beatriz Romero Romero; Auxiliadora Romero Falcón Journal: BMC Pulm Med Date: 2017-05-02 Impact factor: 3.317
Authors: Felicia C Allen-Ramey; Linda M Nelsen; Joseph B Leader; Dione Mercer; Henry Lester Kirchner; James B Jones Journal: Allergy Asthma Clin Immunol Date: 2013-08-07 Impact factor: 3.406
Authors: Eugene R Bleecker; Andrew N Menzies-Gow; David B Price; Arnaud Bourdin; Stephen Sweet; Amber L Martin; Marianna Alacqua; Trung N Tran Journal: Am J Respir Crit Care Med Date: 2020-02-01 Impact factor: 21.405