Characteristics of Asthma Visits to Physician Offices in the United States: 2012-2015 National Ambulatory Medical Care Survey.

Objective-This report describes asthma visits to offices of nonfederally employed U.S. physicians. Methods-Asthma visits are defined by the first-listed diagnosis from National Ambulatory Medical Care Survey data. Asthma visit rates among the general population and among persons with asthma (at-risk rates) were estimated. Trends from 2001 through 2016 were assessed. Asthma visit characteristics were assessed for the period 2012-2015 (the diagnostic coding system was changed to the International Classification of Diseases, 10th Revision, Clinical Modification in 2016). The consistency of visit characteristics with national asthma guidelines was also assessed. Results-From 2001 through 2016, population-based asthma visit rates declined from 40.2 to 30.7 visits per 1,000 persons, and at-risk visit rates from 55.5 to 36.7 visits per 100 persons with asthma. During 2012-2015, there was an annual average of 10.2 million asthma visits: 63.5% were by non-Hispanic white persons, 53.8% by female patients, and 32.5% by children under age 15 years. Population and at-risk visit rates were similar across sex and racial and ethnic groups. Children aged 0-4 years had the highest at-risk asthma visit rate. Primary care physicians saw 60.0% of asthma visits. Asthma severity was documented in 34.5% of visits, asthma control in 40.9%, spirometry in 14.9%, and peak flow in 3.3%. Asthma education was provided in 21.4% of asthma visits and asthma action plans in 9.9%. Bronchodilators were the most commonly mentioned medication class (24.9%). A quick-acting relief medication was the most frequently mentioned (albuterol, 16.9%), followed by asthma-control medications (montelukast, 4.7%; fluticasone-salmeterol, 3.7%; and prednisone, 2.7%). Conclusions-Asthma physician office visit rates declined from 2001 through 2016. During 2012-2015, primary care providers saw nearly two-thirds of asthma visits. Physician adherence to documenting asthma severity or control and providing patient education appeared low. Quick-acting relief medication was the most frequently prescribed medication.