In the Journals

Lower asthma medication ratio correlated to more frequent flare-ups

Children with persistent asthma who did not consistently fill controller medications were more likely to have asthma exacerbations, according to a study published online.

Louis Vernacchio, MD, MSc, and colleagues from the Pediatric Physicians’ Organization at Children’s (PPOC), an independent practice association affiliated with Boston Children’s Hospital, reported on commercially insured children ages 5 to 17 years cared for by pediatricians within their organization who had persistent asthma in 2008, 2009 or 2010.

Louis Vernacchio, MD 

Louis Vernacchio

The researchers examined the correlation of various process measures of asthma care with the occurrence of asthma exacerbations and found that filling no controller prescriptions (versus with filling one or more) and the asthma medication ratio, defined as the number of controller prescriptions filled divided by the total number of asthma prescriptions filled, both correlated strongly with asthma exacerbations.

The authors noted that 4% of subjects filled no controller prescriptions at all within a calendar year and were at substantially increased risk of asthma attacks compared with children who had filled at least one controller prescription. Furthermore, the researchers found that those in the two lowest quartiles of the asthma medication ratio had a significantly higher risk of asthma flare-ups compared with those in the highest level of the ratio.

“This analysis underscores the importance of controller medication use in reducing the risk of asthma exacerbations in children with persistent asthma and provides some concrete ways that administrative data can be used to monitor appropriate treatment within a pediatric network,” Vernacchio told Infectious Diseases in Children.

Disclosure: Vernacchio reports no relevant financial disclosures.

Louis Vernacchio, MD, MSc, can be reached at 33 Pond Avenue, Suite 102B, Brookline, MA 02445; Email: louis.vernacchio@childrens.harvard.edu.

Children with persistent asthma who did not consistently fill controller medications were more likely to have asthma exacerbations, according to a study published online.

Louis Vernacchio, MD, MSc, and colleagues from the Pediatric Physicians’ Organization at Children’s (PPOC), an independent practice association affiliated with Boston Children’s Hospital, reported on commercially insured children ages 5 to 17 years cared for by pediatricians within their organization who had persistent asthma in 2008, 2009 or 2010.

Louis Vernacchio, MD 

Louis Vernacchio

The researchers examined the correlation of various process measures of asthma care with the occurrence of asthma exacerbations and found that filling no controller prescriptions (versus with filling one or more) and the asthma medication ratio, defined as the number of controller prescriptions filled divided by the total number of asthma prescriptions filled, both correlated strongly with asthma exacerbations.

The authors noted that 4% of subjects filled no controller prescriptions at all within a calendar year and were at substantially increased risk of asthma attacks compared with children who had filled at least one controller prescription. Furthermore, the researchers found that those in the two lowest quartiles of the asthma medication ratio had a significantly higher risk of asthma flare-ups compared with those in the highest level of the ratio.

“This analysis underscores the importance of controller medication use in reducing the risk of asthma exacerbations in children with persistent asthma and provides some concrete ways that administrative data can be used to monitor appropriate treatment within a pediatric network,” Vernacchio told Infectious Diseases in Children.

Disclosure: Vernacchio reports no relevant financial disclosures.

Louis Vernacchio, MD, MSc, can be reached at 33 Pond Avenue, Suite 102B, Brookline, MA 02445; Email: louis.vernacchio@childrens.harvard.edu.