Level of Asthma Controller Therapy Before Admission to the Hospital

Abstract : BACKGROUND: In asthma, choice of controller therapy and adherence to treatment can affect the risk of future severe exacerbations leading to hospitalization. OBJECTIVE: Our objective was to characterize treatment dispensation profiles before hospital admission for asthma. METHODS: Using a 1/97th random sample of the national French claims data, patients with asthma aged 6 to 40 years were identified between 2006 and 2014. Patients with subsequent asthma-related hospitalization were selected. On the basis of controller therapy dispensed in the 12 months before admission, treatment profiles were categorized into clusters, using Ward's minimum-variance hierarchical clustering method. RESULTS: Of 17,846 patients with asthma, we identified 275 patients (1.5%) with an asthma-related hospitalization. Three distinct clusters were identified. The first cluster (63.6%) included patients with few dispensations of any controller medication (\\textless1 unit). The second cluster (32.4%) consisted of patients with frequent dispensations of long-acting beta agonists (LABAs)/inhaled corticosteroids (ICS) in fixed-dose combinations. The third cluster (4%) comprised patients receiving free combinations of ICS and LABAs, with more dispensations of LABAs than of ICS. CONCLUSIONS: In France, before an asthma-related hospitalization, more than 60% of patients received little controller therapy and 4% were exposed to higher dispensation of LABAs than of ICS. These results indicate that a large fraction of asthma-related hospitalizations can potentially be prevented with better pharmacotherapy.
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Submitted on : Friday, July 13, 2018 - 4:45:15 PM
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Manon Belhassen, Carole Langlois, L. Laforest, Alexandra Lelia Dima, Marine Ginoux, et al.. Level of Asthma Controller Therapy Before Admission to the Hospital. Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 2016, ⟨10.1016/j.jaip.2016.06.012⟩. ⟨hal-01838970⟩

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