Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
OCHIN, Inc, Portland, OR, USA.
J Asthma. 2023 Feb;60(2):360-367. doi: 10.1080/02770903.2022.2051545. Epub 2022 Mar 20.
Medication maintenance is critical in the management of asthma. We investigated the differences in electronic health record (EHR) documentation of medication refills for Spanish- and English-speaking Latino children and non-Hispanic white children by examining rates of albuterol rescue inhaler refills from 2005 to 2017, and and inhaled corticosteroid refills from 2015 to 2017 in a multi-state network of community health centers (CHCs).
We used data from the ADVANCE network of CHCs. Our sample consisted of children aged 3-17, with a diagnosis of asthma and either albuterol or inhaled corticosteroid prescriptions ( = 39,162; = 4,738 children, respectively). Negative binomial regression was used to calculate rates of refills per prescription adjusted for relevant patient-level covariates. Analyses stratified by asthma severity were also conducted.
English-speaking Latino children had lower rates of albuterol refills compared with non-Hispanic white children (rate ratio [RR] = 0.88, 95% confidence interval [CI]: 0.80-0.98), a trend that persisted among children with moderate/severe persistent asthma severity (RR = 0.85, 95% CI: 0.76-0.95). Spanish-speaking Latino and non-Hispanic white children had similar albuterol refills. Inhaled corticosteroid refill rates were comparable between all groups.
In a multi-state network, these findings suggest that CHCs deliver equitable asthma care related to prescription refills between their Latino and white patients, but there is still opportunity for providers to ensure that their English-speaking Latino patients have access to necessary emergency asthma medication.
药物维持是哮喘管理的关键。我们通过检查 2005 年至 2017 年西班牙裔和英语裔拉丁裔儿童和非西班牙裔白人儿童沙丁胺醇急救吸入器的补充率,以及 2015 年至 2017 年吸入性皮质类固醇的补充率,来研究电子健康记录 (EHR) 中药物补充的西班牙语和英语拉丁裔儿童和非西班牙裔白人儿童的记录差异。
我们使用来自 ADVANCE 社区卫生中心网络的数据。我们的样本包括年龄在 3-17 岁之间、有哮喘诊断且有沙丁胺醇或吸入性皮质类固醇处方的儿童( = 39,162;分别为 4,738 名儿童)。使用负二项回归计算调整了相关患者水平协变量的每个处方的补充率。还按哮喘严重程度进行了分层分析。
与非西班牙裔白人儿童相比,英语西班牙语裔拉丁裔儿童的沙丁胺醇补充率较低(比率比 [RR] = 0.88,95%置信区间 [CI]:0.80-0.98),这种趋势在中/重度持续性哮喘严重程度的儿童中仍然存在(RR = 0.85,95% CI:0.76-0.95)。西班牙语裔拉丁裔和非西班牙裔白人儿童的沙丁胺醇补充率相似。所有组的吸入性皮质类固醇补充率相当。
在一个多州网络中,这些发现表明 CHC 在其拉丁裔和白人患者之间提供了平等的与处方补充相关的哮喘护理,但提供者仍有机会确保他们的英语西班牙语裔患者能够获得必要的紧急哮喘药物。