The 130th Annual Meeting of APHA

Abstract #49251

Seijeoung Kim, PhD¹, Aaron Rotherberg², Judilyn Bult, PharmD², and Gordon D Schiff, MD². (1) Hektoen Research Institute, 1900 W. Polk St., Administration building, room #901, Chicago, IL 60612, 312-633-3662, skim@hektoen.org, (2) Cook County Hospital, 1900 W. Polk St., Administration building, Room #901, Chicago, IL 60612

Asthma is the third leading cause of preventable hospitalization in the US. Inappropriate therapy is a major contributor to asthma morbidity. An insufficiently implemented recommendation for asthma treatment is the use of maintenance inhaled steroids for chronic asthma patients. Steroid use was associated with a 50% reduction in hospitalization relative to asthma patients who take no inhaled steroids. By defining the population at risk and tracking medication use in a systematic manner, asthma care and adherence to the care guideline can be substantially improved. From an outpatient pharmacy database in a pubic hospital clinic, two prescription data were linked to analyze use of inhaled steroids in relation to beta-agonist inhalers.

Methods: All beta-agonist prescriptions for a 12-month period and inhaled steroid prescriptions for 15 months were linked to capture steroid sprays for the time period plus 3 additional months. The ratio of annual beta-agonist to inhaled steroid prescriptions was computed.

Results: 51% of the patients received zero to one beta-agonist to steroid ratio, and 31% received a one to three ratio. 17% of the patients used greater than three beta-agonists per one inhaled steroid. On the other hand, the citywide beta-agonist to steroid ratio showed much higher beta-agonist use relation to inhaled steroid use.

Conclusions: By linking medication prescription databases for 2 key asthma drugs, patterns of care and compliance to the national guideline were clearly depicted. The results of analyses, which indicated the use of beta-agonists without steroids and the patients receiving steroid inhalers without beta-agonists, also showed distinct areas for improvement.

Learning Objectives:

• to understand the importance of systematic evaluation of care by utilizing and linking existing databases
• to acknowledge that the evidence-based treatment for asthma patients is enhanced through improving patient care information system

Keywords: Information System Integration, Asthma

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.