RATIONALE: An asthma medication ratio (AMR) greater than 0.5 has been shown to predict future asthma exacerbations. This study explores the impact of increasing or decreasing ICS/LABA use over a 7 year period on achieving AMR of greater than 0.5.
METHODS: Retrospective, observational study utilizing pharmacy and medical claims from a medical group from 01/2003-12/2010. All patients with greater than 1 asthma diagnosis (493.xx) and with greater than 1 asthma inhaled medication dispensed in each year of eligibility were included. ThemAMR5total ICS controllers dispensed/total ICS controllers dispensed + albuterol dispensed. Proportion of ICS/LABA use was determined annually as number of ICS/ LABA canisters dispensed O sum of ICS/LABA and ICS dispensed. Generalized linear mixed model (GLM) was used to assess the effect of incremental change in ICS/LABA on mAMR over 7 yeasrs adjusting for differences in resource utilization, time and asthma medication use.
RESULTS: 990 patients met all criteria mean age (6SD) of 35 (618) years. About 15% of the patients used albuterol and oral corticosteroids during the identification period. Overall, mean mAMR increases over time while mean albuterol decreases over time. Adjusting for covariates, a 10% increase in ICS/LABAuse was associated with a 9%increase (adjusted OR 1.09, 95% CI 1.06, 1.12) in the likelihood of achievingmAMR greater than 0.5 while a 50% increase in ICS/LABA use was associated with a 53% (OR 1.53, 95% CI 1.31, 1.8) increased likelihood of obtaining mAMR greater than 0.5.
CONCLUSIONS: Increase in ICS/LABA use over time in a population of asthma patients was significantly associated with a higher likelihood of achieving a mAMR of greater than 0.5. (GSK FLT114941).
