Regis University School of Pharmacy, Denver, CO, USA.
AAADRS Clinical Research Center, Coral Gables, FL, USA.
J Asthma. 2020 Sep;57(9):959-967. doi: 10.1080/02770903.2019.1628253. Epub 2019 Jul 2.
To compare healthcare resource utilization (HCRU), healthcare expenditures, and work productivity and activity impairment within a general asthma population with persistent asthma and evidence of allergy (PA-EA) and persistent asthma with no evidence of allergy (PA-NEA). We conducted a retrospective analysis of survey responses and claims from the Observational Study of Asthma Control and Outcomes (OSACO) study. Eligible patients with persistent asthma aged ≥12 years were sent four surveys over 15 months. Regression models were used to assess the association between: (1) PA-EA (defined as a positive response to a survey question about hay fever/seasonal allergies AND ≥1 diagnostic code for atopic conditions) and HCRU and expenditures; and (2) PA-EA and Work Productivity and Activity Impairment (WPAI)-Asthma questionnaire scores (vs. PA-NEA). Adjusted data showed that, vs. PA-NEA ( = 312), patients with PA-EA ( = 971) incurred 1.34-times more all-cause prescriptions (95% confidence interval [CI], 1.20-1.48), $132.79 higher prescription costs (95% CI, $22.03-243.56), and $926.11 higher all-cause total healthcare costs (95% CI, $279.67-1572.54), per 4-month period. Patients with PA-EA were 4.1% less productive while working (95% CI, 3.75-4.48%) and experienced a 6.5% reduction in all activities (95% CI, 6.11-6.88%) vs. those with PA-NEA. Patients with PA-EA had greater HCRU, healthcare expenditures, and lower productivity compared with those patients with PA-NEA. These results highlight the burden of atopy in patients with persistent asthma and underscore the importance of allergic endotype identification for more vigilant disease management.
比较哮喘控制和结局观察研究(OSACO)中具有持续性哮喘且存在过敏证据(PA-EA)和具有持续性哮喘且无过敏证据(PA-NEA)的一般哮喘人群中的医疗资源利用(HCRU)、医疗支出以及工作生产力和活动受损情况。我们对调查回复和 OSACO 研究的索赔进行了回顾性分析。将年龄≥12 岁的符合条件的持续性哮喘患者在 15 个月内发送了四次调查。回归模型用于评估以下两个方面之间的关联:(1)PA-EA(定义为对花粉症/季节性过敏的调查问题的阳性反应和/或≥1 个特应性疾病的诊断代码)与 HCRU 和支出;(2)PA-EA 与工作生产力和活动受损(WPAI)-哮喘问卷评分(与 PA-NEA 相比)。调整数据显示,与 PA-NEA(n=312)相比,PA-EA(n=971)患者的所有原因处方增加了 1.34 倍(95%置信区间[CI],1.20-1.48),处方费用增加了 132.79 美元(95%CI,22.03-243.56 美元),所有原因总医疗费用增加了 926.11 美元(95%CI,279.67-1572.54 美元),每 4 个月。PA-EA 患者的工作生产力降低了 4.1%(95%CI,3.75-4.48%),所有活动减少了 6.5%(95%CI,6.11-6.88%),而 PA-NEA 患者的工作生产力降低了 4.1%。与 PA-NEA 患者相比,PA-EA 患者的 HCRU、医疗支出更高,生产力更低。这些结果突出了特应性在持续性哮喘患者中的负担,并强调了确定过敏表型对于更严格疾病管理的重要性。