Inhaled corticosteroid use in asthmatic children receiving Ohio Medicaid: trend analysis, 1997-2001.

Title

Inhaled corticosteroid use in asthmatic children receiving Ohio Medicaid: trend analysis, 1997-2001.

Creator

Stevenson MD; Heaton PC; Moomaw CJ; Bean JA; Ruddy RM

Publisher

Annals of Allergy, Asthma & Immunology

Date

2008
2008-06

Description

BACKGROUND: In 1997, national guidelines emphasized that inhaled corticosteroids (ICSs) are key therapy for individuals with all classes of persistent asthma, including children. OBJECTIVE: To examine the effect of these guidelines via time-trend analysis of ICS dispensation among children with asthma and Ohio Medicaid insurance. METHODS: A retrospective cross-sectional analysis by yearly cohorts was performed. From January 1, 1997, to December 31, 2001, all children from birth to the age of 18 years with 6 months of Ohio Medicaid enrollment or more, 1 or more asthma diagnoses associated with a provider claim, and 1 or more prescription claims for an asthma medication in a given calendar year were identified using claims data. The daily beclomethasone equivalent (BME) dose, the daily albuterol equivalent dose, and asthma-related health care use were calculated for each child within each yearly cohort. A time-trend regression analysis of subjects enrolled in all 5 years examined factors associated with BME. RESULTS: A total of 77,557 children met the study criteria. Among the 1,475 children enrolled during all 5 years, year of enrollment was a positive independent predictor of BME after adjustment for age, race, sex, systemic steroid bursts, albuterol equivalent dose, and health care use (P \textless .001). CONCLUSIONS: The daily BME dose significantly increased for children with asthma insured by Ohio Medicaid from 1997 to 2001. However, the percentages of children receiving both ICS and a therapeutic BME dose were alarmingly low. The mean BME dose was particularly low among children with 1 or more emergency department visits, no hospitalizations, and 3 or fewer physician visits for asthma per year, suggesting that broader efforts to target this group are needed.

Subject

Female; Male; Ohio; Child; Infant; United States; Sex Factors; Human; Cross Sectional Studies; Adolescence; Retrospective Design; Regression; Preschool; Newborn; Administration; Inhalation; Ambulatory Care – Statistics and Numerical Data; Emergency Service – Statistics and Numerical Data; Blacks – Statistics and Numerical Data; Whites – Statistics and Numerical Data; Medicaid – Statistics and Numerical Data; Hospitalization – Statistics and Numerical Data; Adrenal Cortex Hormones – Therapeutic Use; Adrenal Cortex Hormones – Administration and Dosage; Asthma – Diagnosis; Asthma – Drug Therapy; Asthma – Ethnology; Drug Utilization – Statistics and Numerical Data; Drug Utilization – Trends

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

538–544

Issue

6

Volume

100

Citation

Stevenson MD; Heaton PC; Moomaw CJ; Bean JA; Ruddy RM, “Inhaled corticosteroid use in asthmatic children receiving Ohio Medicaid: trend analysis, 1997-2001.,” NEOMED Bibliography Database, accessed March 19, 2024, https://neomed.omeka.net/items/show/6049.