Process quality measures and asthma exacerbations in the Medicaid population

Yong, Pierre L; Werner, Rachel M.

doi:10.1016/j.jaci.2009.07.027

Cited by 28 publications

(19 citation statements)

References 20 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, our main findings are in line with previous studies that reported fewer asthma-related hospitalisations and emergency room visits when the controller-to-total asthma drug ratio was o50% [4,5]. A lower risk of belonging to the high ratio group was found in controller-treated patients with at least two refills of OCSs (OR50.89, 95% CI 0.82-0.98) [9].…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

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

Laforest

Licaj

Devouassoux

et al. 2014

European Respiratory Journal

View full text Add to dashboard Cite

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

show abstract

Section: Discussionsupporting

confidence: 91%

“…Authors have investigated ratios measuring the proportion of dispensed controllers in total asthma therapy as a marker of the quality of care [4,5]. Studies using these ratios have consistently shown higher levels of asthma-related hospital admissions and emergency room visits for patients with lower ratios [6].…”

Section: Introductionmentioning

confidence: 99%

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

Laforest

Licaj

Devouassoux

et al. 2014

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…39 Conversely, previous database analyses have found that patients with persistent asthma who have a medication refill pattern reflecting a higher (>0.5) controller/total asthma medication ratio (defined as the number of controllers dispensed divided by the total number of controllers plus SABAs refilled) were less likely to have exacerbations. [40][41][42] The results of this analysis appear to contradict in 2 important ways this prior work. The exacerbation group refilled their controller medications more often than the comparison cohort without exacerbations.…”

Section: Discussioncontrasting

confidence: 78%

Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma

Ivanova

Bergman

Birnbaum

et al. 2012

Journal of Allergy and Clinical Immunology

258

168

View full text Add to dashboard Cite

“…This cut point was chosen given previous evidence at the patient level demonstrating that an AMR ,0.5 is associated with increased utilization (eg, ED visitation or hospitalization) and lower quality of life. 19,21,29,30 Second, we explored a potential dose effect using quintiles, placing each pharmacy into 1 of 5 groups based on ascending Ph-AMR. Finally, Ph-AMR was treated as a continuous variable.…”

Section: Calculation Of the Ph-amrmentioning

confidence: 99%