Use of ICS/LABA on Asthma Exacerbation Risk in XXXX Within a Medical Group.

@entity1 @entity565 @entity3045
BACKGROUND: Asthma medication ratio (AMR) >=    0.5 has been shown to predict @entity565 exacerbations. This study explores the impact of increasing or decreasing inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) use over a 7-year period on achieving an AMR of >=    0.5. OBJECTIVES: To (a) assess the impact of increasing use of ICS/LABAs on changes in a modified AMR (mAMR) and (b) examine @entity565 risk over time as measured by an mAMR over a 7-year period, adjusting for differences in baseline characteristics. METHODS: This is a retrospective, observational study using pharmacy and medical claims from a medical group from January 1, 2003, to December 31, 2010. All @entity1 with >=    1 @entity565 diagnosis (ICD-9-CM, 493.xx) with >=    1 inhaled @entity565 medication dispensed in each year of eligibility were included. The mAMR   =   total ICS controllers dispensed/(total ICS controllers dispensed   +   @entity3045 dispensed). The proportion of ICS/LABA use was determined as the number of ICS/LABA canisters dispensed/(total of ICS/LABA   +   ICS dispensed). Generalized linear mixed models were used to assess the effect of incremental change in ICS/LABA use on mAMR over 7 years, adjusting for differences in resource utilization, time, and @entity565 medication use.   RESULTS: Nine hundred ninety @entity1 (mean age [     SD] 34.7 years [     18.2], 61.7% female) met all criteria. Overall, mean mAMR increased over time, while mean @entity3045 use decreased over time. Adjusting for covariates, we found that a 10% increase in ICS/LABA use was associated with a 9% increase (adjusted OR   =   1.09, 95% CI   =   1.06-1.12) in the likelihood of achieving an mAMR   >=    0.5, while a 50% increase in ICS/LABA use was associated with a 53% increase (OR   =   1.53, 95% CI   =   1.31-1.80) in the likelihood of achieving an mAMR   >=    0.5. CONCLUSIONS: Increase in ICS/LABA use over time in a population of @entity565 @entity1 was significantly associated with a higher likelihood of achieving an mAMR   >=    0.5.
