Improving asthma outcomes in large populations

Schätz, Michael; Zeiger, Robert S.

doi:10.1016/j.jaci.2011.03.027

Cited by 40 publications

(30 citation statements)

References 22 publications

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“…Studies using these ratios have consistently shown higher levels of asthma-related hospital admissions and emergency room visits for patients with lower ratios [6]. The impact of ratios on oral corticosteroids (OCSs) has been less extensively explored.…”

Section: Introductionmentioning

confidence: 99%

Asthma drug ratios and exacerbations: claims data from universal health coverage systems

et al. 2014

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In claims data, controller-to-total asthma drug ratios may reflect adequacy of disease management. We verified whether asthma patients with high ratios (o50%) experienced fewer asthmarelated outcomes. Two ratios were studied: that of the inhaled corticosteroids to total asthma drug (ICS/ R03) and that of the inhaled corticosteroids plus leukotriene antagonist receptors-to-total asthma drug (ICS+LTRA/R03).Patients aged 13-40 years, with o3 respiratory drugs dispensed prescriptions in 2005 were selected from the French national claims data. After excluding null ratios, two groups were defined according to ratio values in 2007: low-ratio group (0%,ratio,50%) and high-ratio group (ratio o50%). For both ratios, asthma-related outcomes and medical-resource utilisation were compared between groups.Of 2162 patients (mean age 27 years and 52% female), patients with non-null ratios were 81% and 85% for ICS/R03 and ICS+LTRA/R03 ratios, respectively. Patients with high ratios were less likely to receive oral corticosteroids than those in the low-ratio group (relative risk 0.79, 95% CI 0.72-0.88, and 0.80, 95% CI 0.72-0.88, for ICS/R03 and ICS+LTRA/R03, respectively). High ratio groups also presented fewer asthmarelated hospitalisations. Significant negative correlations were also observed for both ratios, when studied quantitatively, according to patients' dispensed level of oral corticosteroids in 2007.In claims data, both ICS/R03 and ICS+LTRA/R03 o50% were related to fewer asthma-related outcomes. Ratios should be explored to identify asthma patients at risk of exacerbations. Low ratios can be considered as risk factors of exacerbation whatever the underlying cause. @ERSpublications Asthma patients with therapeutic ratios o50% had fewer asthma exacerbation markers, suggesting better control

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Section: Introductionmentioning

confidence: 99%

Asthma drug ratios and exacerbations: claims data from universal health coverage systems

et al. 2014

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“…22,23 New or redesigned processes could benefit from novel performance measures that illustrate the quality of care that reaches patients. 24 Ultimately, we hope to grow collaborative, cross-institutional, and community-based interventions aimed at reducing asthma morbidity and disparities. As a first step, we sought to bring together hospitalbased utilization data and prescription medication fill data from in-county pharmacies managed by a single nationwide chain.…”

Section: What This Study Adds: a Newly Developedmentioning

confidence: 99%

“…The AMR is currently used by physicians and managed care organizations to improve adherence to evidence-based guidelines and has shown consistent associations with symptom control. [19][20][21]24,30 Guided by the AMR and motivated by deep disparities across our community, 4 we developed the Ph-AMR as a means of harnessing geographic variation to inform allocation of resources to those pharmacies and areas in most need of improvement. 33,34 The Ph-AMR could identify pharmacies that are underdispensing controller medications while also facilitating a deeper understanding among pharmacies of their population in ways that would prompt the design of innovative interventions.…”

Section: Figurementioning

confidence: 99%

The Pharmacy-Level Asthma Medication Ratio and Population Health

et al. 2015

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“…32 The AMR is currently used by physicians and managed care organizations to improve adherence to evidence-based guidelines and has shown consistent associations with symptom control. [19][20][21]24,30 Guided by the AMR and motivated by deep disparities across our community, 4 we developed the Ph-AMR as a means of harnessing geographic variation to inform allocation of resources to those pharmacies and areas in most need of improvement. 33,34 The Ph-AMR could identify pharmacies that are underdispensing controller medications while also facilitating a deeper understanding among pharmacies of their population in ways that would prompt the design of innovative interventions.…”

Section: Figurementioning

confidence: 99%

The Pharmacy-Level Asthma Medication Ratio and Population Health

2015

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Improving asthma outcomes in large populations

Cited by 40 publications

References 22 publications

Asthma drug ratios and exacerbations: claims data from universal health coverage systems

Asthma drug ratios and exacerbations: claims data from universal health coverage systems

The Pharmacy-Level Asthma Medication Ratio and Population Health

The Pharmacy-Level Asthma Medication Ratio and Population Health

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