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Titolo:
Underutilization of controller and rescue medications among older adults with asthma requiring hospital care
Autore:
Hartert, TV; Togias, A; Mellen, BG; Mitchel, EF; Snowden, MS; Griffin, MR;
Indirizzi:
Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 Dept Med, Nashville, TN 37232 USA Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 event Med, Nashville, TN 37232 USA Vanderbilt Univ, Sch Med, Div Allergy Pulm & Crit Care Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 Care Med, Nashville, TN 37232 USA Johns Hopkins Univ, Sch Med, Dept Med, Div Clin Immunol, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 mmunol, Baltimore, MD 21205 USA Johns Hopkins Univ, Sch Med, Dept Med, Div Resp & Crit Care Med, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 re Med, Baltimore, MD 21205 USA Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Biostat Sect, Winston Salem, NC 27103 USA Wake Forest Univ Winston Salem NC USA 27103 , Winston Salem, NC 27103 USA
Titolo Testata:
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
fascicolo: 6, volume: 48, anno: 2000,
pagine: 651 - 657
SICI:
0002-8614(200006)48:6<651:UOCARM>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
BETA-AGONIST USE; MORTALITY; DEATH; RISK; PATTERNS; COHORT;
Keywords:
asthma; older parsons; inhaled corticosteroids; epidemiology; pharmacoepidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Hartert, TV Vanderbilt Univ, Sch Med, Ctr Lung Res, T-1217 Med Ctr N, Nashville, TN 37232 USA Vanderbilt Univ T-1217 Med Ctr N Nashville TN USA 3723232 USA
Citazione:
T.V. Hartert et al., "Underutilization of controller and rescue medications among older adults with asthma requiring hospital care", J AM GER SO, 48(6), 2000, pp. 651-657

Abstract

BACKGROUND: Asthma causes serious morbidity in older people, but pharmacologic therapy in older people with asthma has never been studied, at least in part because of the difficulty of defining asthma in this population. OBJECTIVE: To determine if older persons enrolled in Medicaid and hospitalized with an exacerbation of asthma receive appropriate outpatient asthma care. DESIGN: Descriptive pharmacoepidemiology of a group of older adults with asthma. SETTING: The Tennessee Medicaid Program. PARTICIPANTS: Persons aged 65 and older, enrolled in the Tennessee Medicaid program, identified through Medicaid's computerized database as having a hospital care visit for asthma in 1992 and who had their diagnosis confirmed by chart review. MEASUREMENT: Medication utilization. RESULTS: The source population included 93,686 persons aged 65 or older enrolled in the Tennessee Medicaid program. The group meeting study criteria included 512 patients with chronic asthma who had a hospital care visit foran asthma exacerbation. Eighty-one percent of these 512 persons with an asthma hospitalization confirmed by chart review were classified as having moderate to severe or potentially fatal asthma. These patients had had a median of 15 outpatient visits in the previous year, and more than half of themhad an outpatient visit in the 14 days before their hospitalization. However, among those with moderate to severe or near fatal asthma only 25% filled prescriptions for inhaled corticosteroids, whereas 52% were taking theophylline, the most commonly prescribed asthma medication in this group. Therewas also high use of antibiotics (29%) and low use of rescue corticosteroids (5%) before the hospital care visit, despite frequent medical encounters. CONCLUSIONS: Despite widespread promulgation of the National Asthma Education Prevention Program guidelines, our study suggests that providers caringfor indigent older subjects with moderate to severe or potentially fatal asthma were not following these guidelines. There was significant underutilization of inhaled anti-inflammatory agents, beta-agonists, and rescue corticosteroids in this population despite frequent outpatient medical care visits.

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Documento generato il 19/01/20 alle ore 20:46:14