| アブストラクト | BACKGROUND: Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. METHODS: Patients with asthma in the US-based Clinformatics DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within +/-2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model. RESULTS: Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced >/=1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with >/=2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids. CONCLUSION: Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management. |
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| 組織名 | Worldwide Epidemiology, GSK, Research Triangle Park, Durham, NC, USA.;Present Address: UCB Biosciences, Epidemiology, Research Triangle Park, Durham,;NC, USA.;Value Outcomes and Epidemiology, PAREXEL International, Research Triangle Park,;Durham, NC, USA.;Present Address: Department of Pharmaceutical Outcomes and Policy, UNC Eshelman;School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.;Worldwide Epidemiology, GSK, Stockley Park, Uxbridge, UK.;Present Address: Chiltern International Ltd, Slough, Berkshire, UK.;Respiratory Medical Franchise, GSK, Research Triangle Park, 5 Moore Drive, PO Box;13398, Durham, NC, 27709, USA. frank.c.albers@gsk.com. |
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