Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma: a cross-sectional study

Jesper Rømhild Davidsen, Jesper Hallas, Jens Søndergaard, René Depont Christensen, Hans Christian Siersted, Malene Plejdrup Hansen, Thomas Bøllingtoft Knudsen, Jesper Lykkegaard, Morten Andersen

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Abstract

OBJECTIVE: Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti-asthmatic drugs with a primary focus on short-acting beta-2-agonists (SABA).

METHODS: In a cross-sectional study 357 subjects, selected by their prescriptions of inhaled beta-2-agonists in Odense Pharmaco-Epidemiological Database, underwent individual clinical assessment including the Asthma Control Questionnaire (ACQ) and spirometry. The associations between uncontrolled asthma (ACQ score ≥ 1.50) and individual anti-asthmatic prescribing were analysed by means of logistic regression.

RESULTS: Clinically uncontrolled asthma was positively associated with SABA use, the association becoming stronger with higher annual quantity of SABA use, odds ratio (OR) 11.1 (95% CI 4.4-28.0) for ≥400 DDD/year. This trend persisted after stratifying for gender, age, and controller treatment. Although subjects using ≥450 DDD/year were all uncontrolled, there was substantial overlap in SABA use between controlled and uncontrolled subjects below this limit. We found no effect modification by age and gender. Use of inhaled corticosteroids protected against uncontrolled asthma, OR 0.51 (95% CI 0.27-0.95).

CONCLUSION: Asthmatics with a high use of SABA frequently have problems with uncontrolled asthma, and users of ICS are protected against uncontrolled asthma. The associations we found were, however, to weak too allow firm conclusions about asthma control for most individual asthma patients.

Original languageEnglish
Pages (from-to)647-653
Number of pages7
JournalPulmonary Pharmacology and Therapeutics
Volume24
Issue number6
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

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Anti-Asthmatic Agents
Asthma
Cross-Sectional Studies
Dichlorodiphenyldichloroethane
Prescriptions
Odds Ratio
Spirometry
Adrenal Cortex Hormones
Logistic Models
Databases

Cite this

Davidsen, J. R., Hallas, J., Søndergaard, J., Christensen, R. D., Siersted, H. C., Hansen, M. P., ... Andersen, M. (2011). Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma: a cross-sectional study. Pulmonary Pharmacology and Therapeutics, 24(6), 647-653. https://doi.org/10.1016/j.pupt.2011.09.001
Davidsen, Jesper Rømhild ; Hallas, Jesper ; Søndergaard, Jens ; Christensen, René Depont ; Siersted, Hans Christian ; Hansen, Malene Plejdrup ; Knudsen, Thomas Bøllingtoft ; Lykkegaard, Jesper ; Andersen, Morten. / Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma : a cross-sectional study. In: Pulmonary Pharmacology and Therapeutics. 2011 ; Vol. 24, No. 6. pp. 647-653.
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title = "Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma: a cross-sectional study",
abstract = "OBJECTIVE: Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti-asthmatic drugs with a primary focus on short-acting beta-2-agonists (SABA).METHODS: In a cross-sectional study 357 subjects, selected by their prescriptions of inhaled beta-2-agonists in Odense Pharmaco-Epidemiological Database, underwent individual clinical assessment including the Asthma Control Questionnaire (ACQ) and spirometry. The associations between uncontrolled asthma (ACQ score ≥ 1.50) and individual anti-asthmatic prescribing were analysed by means of logistic regression.RESULTS: Clinically uncontrolled asthma was positively associated with SABA use, the association becoming stronger with higher annual quantity of SABA use, odds ratio (OR) 11.1 (95{\%} CI 4.4-28.0) for ≥400 DDD/year. This trend persisted after stratifying for gender, age, and controller treatment. Although subjects using ≥450 DDD/year were all uncontrolled, there was substantial overlap in SABA use between controlled and uncontrolled subjects below this limit. We found no effect modification by age and gender. Use of inhaled corticosteroids protected against uncontrolled asthma, OR 0.51 (95{\%} CI 0.27-0.95).CONCLUSION: Asthmatics with a high use of SABA frequently have problems with uncontrolled asthma, and users of ICS are protected against uncontrolled asthma. The associations we found were, however, to weak too allow firm conclusions about asthma control for most individual asthma patients.",
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Davidsen, JR, Hallas, J, Søndergaard, J, Christensen, RD, Siersted, HC, Hansen, MP, Knudsen, TB, Lykkegaard, J & Andersen, M 2011, 'Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma: a cross-sectional study' Pulmonary Pharmacology and Therapeutics, vol. 24, no. 6, pp. 647-653. https://doi.org/10.1016/j.pupt.2011.09.001

Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma : a cross-sectional study. / Davidsen, Jesper Rømhild; Hallas, Jesper; Søndergaard, Jens; Christensen, René Depont; Siersted, Hans Christian; Hansen, Malene Plejdrup; Knudsen, Thomas Bøllingtoft; Lykkegaard, Jesper; Andersen, Morten.

In: Pulmonary Pharmacology and Therapeutics, Vol. 24, No. 6, 12.2011, p. 647-653.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma

T2 - a cross-sectional study

AU - Davidsen, Jesper Rømhild

AU - Hallas, Jesper

AU - Søndergaard, Jens

AU - Christensen, René Depont

AU - Siersted, Hans Christian

AU - Hansen, Malene Plejdrup

AU - Knudsen, Thomas Bøllingtoft

AU - Lykkegaard, Jesper

AU - Andersen, Morten

N1 - Copyright © 2011 Elsevier Ltd. All rights reserved.

PY - 2011/12

Y1 - 2011/12

N2 - OBJECTIVE: Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti-asthmatic drugs with a primary focus on short-acting beta-2-agonists (SABA).METHODS: In a cross-sectional study 357 subjects, selected by their prescriptions of inhaled beta-2-agonists in Odense Pharmaco-Epidemiological Database, underwent individual clinical assessment including the Asthma Control Questionnaire (ACQ) and spirometry. The associations between uncontrolled asthma (ACQ score ≥ 1.50) and individual anti-asthmatic prescribing were analysed by means of logistic regression.RESULTS: Clinically uncontrolled asthma was positively associated with SABA use, the association becoming stronger with higher annual quantity of SABA use, odds ratio (OR) 11.1 (95% CI 4.4-28.0) for ≥400 DDD/year. This trend persisted after stratifying for gender, age, and controller treatment. Although subjects using ≥450 DDD/year were all uncontrolled, there was substantial overlap in SABA use between controlled and uncontrolled subjects below this limit. We found no effect modification by age and gender. Use of inhaled corticosteroids protected against uncontrolled asthma, OR 0.51 (95% CI 0.27-0.95).CONCLUSION: Asthmatics with a high use of SABA frequently have problems with uncontrolled asthma, and users of ICS are protected against uncontrolled asthma. The associations we found were, however, to weak too allow firm conclusions about asthma control for most individual asthma patients.

AB - OBJECTIVE: Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti-asthmatic drugs with a primary focus on short-acting beta-2-agonists (SABA).METHODS: In a cross-sectional study 357 subjects, selected by their prescriptions of inhaled beta-2-agonists in Odense Pharmaco-Epidemiological Database, underwent individual clinical assessment including the Asthma Control Questionnaire (ACQ) and spirometry. The associations between uncontrolled asthma (ACQ score ≥ 1.50) and individual anti-asthmatic prescribing were analysed by means of logistic regression.RESULTS: Clinically uncontrolled asthma was positively associated with SABA use, the association becoming stronger with higher annual quantity of SABA use, odds ratio (OR) 11.1 (95% CI 4.4-28.0) for ≥400 DDD/year. This trend persisted after stratifying for gender, age, and controller treatment. Although subjects using ≥450 DDD/year were all uncontrolled, there was substantial overlap in SABA use between controlled and uncontrolled subjects below this limit. We found no effect modification by age and gender. Use of inhaled corticosteroids protected against uncontrolled asthma, OR 0.51 (95% CI 0.27-0.95).CONCLUSION: Asthmatics with a high use of SABA frequently have problems with uncontrolled asthma, and users of ICS are protected against uncontrolled asthma. The associations we found were, however, to weak too allow firm conclusions about asthma control for most individual asthma patients.

U2 - 10.1016/j.pupt.2011.09.001

DO - 10.1016/j.pupt.2011.09.001

M3 - Article

VL - 24

SP - 647

EP - 653

JO - Pulmonary Pharmacology

JF - Pulmonary Pharmacology

SN - 1094-5539

IS - 6

ER -