Tatiana Makhinova|Jamie C. Barner|Katherine Richards|Karen L. Rascati
Asthma Controller Medication Adherence, Risk of Exacerbation, and Use of Rescue Agents Among Texas Medicaid Patients with Persistent Asthma
The University of Texas at Austin
adherence asthma longterm controller medications one key drivers improve asthma management among patients persistent asthma suboptimal use controller medications found associated frequent use oral corticosteroids ocs studies exist regarding relationship adherence controller therapy use shortacting beta2agonists sabas better understanding association adherence asthma controller agents use reliever medications help health care providers decision makers enhance asthma managementto determine relationship asthma controller adherence risk exacerbation requiring ocs use asthma rescue agentstexas medicaid claims data january 1 2008 august 31 2011 retrospectively analyzed continuously enrolled patients aged 563 years primary diagnosis asthma icd9cm code 493 4 prescription claims asthma medication 1 year persistent asthma included index date date first asthma controller prescription patients followed 1 year primary outcome variables saba dichotomous less 6 vs 6 ocs continuous use primary independent variable adherence proportion days covered pdc asthma longterm controller medications covariates included demographics nonstudy medication utilization multivariate logistic linear regression analyses employed address study objectivethe study sample n 32172 aged 150 145 years adherence controller therapy 322 197 mean number saba claims 37 31 patients 15 claims 732 whereas 194 6 saba claims mean number ocs claims 10 14 adherent pdc 50 patients 967 1967 95 ci 18262120 likely 6 saba claims compared nonadherent pdc less 50 patients p less 0001 ocs use adherent patients 011 fewer claims compared nonadherent patients p less 0001 importantly patients 6 saba claims 07 ocs claims compared patients less 6 claims saba p less 0001 odds 6 saba claims higher concurrent dual therapy users older age males african americans higher number nonstudy medications p less 0001 dual therapy users younger age hispanic ethnicity higher number nonstudy medications associated increase ocs use p less 0005adherence longterm controller medications suboptimal among patients asthma adherent patients fewer ocs claims indicating adherence controller therapy critical preventing asthma exacerbations requiring ocs use although positive relationship adherence longterm controller medication saba use increased saba use served predictor increased ocs use indicates poor asthma control health care providers aware ocs saba use among patients adherent nonadherent asthma controller medications