TABLE 3.
Exacerbation Patterns Before and After Escalation
| Before Escalation (n = 5,044) | After Escalation (n = 5,044) | |
|---|---|---|
| Period length, days, mean (SD) | 136.1 (105.2) | 251.6 (138.9) |
| Period length, days, median (p25, p75) | 110 (41, 218) | 365 (101, 365) |
| Time to first exacerbation, days, mean (SD) | 48.8 (80.8) | 68.3 (99.2) |
| Time to first exacerbation, median (p25, p75) | 1.00 (1.00, 66.50) | 8.00 (1.00, 106.0) |
| Patients with asthma exacerbations, n (%) | ||
| Any asthma exacerbationa | 1,108 (22.0) | 1,038 (20.6) |
| With hospitalization | 27 (2.4) | 23 (2.2) |
| With ED or urgent care facility visit only | 123 (11.1) | 82 (7.9) |
| With office visit and OCS pharmacy claim within 7 days | 958 (86.5) | 933 (89.9) |
| Asthma exacerbations PPPY, mean (SD) | ||
| Number of asthma exacerbations | 1.60 (5.1) | 0.75 (2.9) |
| Number of exacerbations with hospitalization | 0.03 (0.7) | 0.03 (0.7) |
| Number of exacerbations with ED or urgent care facility visit only | 0.18 (1.8) | 0.05 (0.6) |
| Number of exacerbations with office visit and OCS pharmacy claim within 7 days | 1.39 (4.8) | 0.67 (2.8) |
| Uncontrolled asthma,b n (%) | 2,095 (41.5) | 2,068 (41.0) |
| HCRU per category PPPY, mean (SD)c | ||
| All-cause | ||
| Ambulatory care visits | 24.0 (26.7) | 19.3 (21.3) |
| Emergency services visits | 1.3 (5.5) | 1.0 (4.1) |
| Inpatient hospital admissions | 0.10 (1.09) | 0.09 (0.85) |
| Asthma-related | ||
| Ambulatory care visits | 8.5 (13.4) | 4.6 (8.1) |
| Emergency services visits | 0.4 (2.9) | 0.1 (1.2) |
| Inpatient hospital admissions | 0.08 (1.04) | 0.06 (0.80) |
aAsthma exacerbation defined hierarchically as an asthma-related hospitalization, ICD-9-CM code 493.xx in the primary position, an asthma-related ED or urgent care facility visit, ICD-9-CM code 493.xx in the primary position, or an asthmarelated office visit, ICD-9-CM code 493.xx in any position and a pharmacy claim for a systemic (oral or injectable) OCS within ± 7 days of the claim. Proportions do not account for variation in observation period.
bUncontrolled asthma defined as ≥4 SABA claims per year, ≥ 1 claim for an OCS, or ≥ 1 asthma-related ED or hospitalization with ICD-9-CM code 493.xx in the primary position.
cUtilization reported PPPY to account for variable observation time among all patients.
ED = emergency department; HCRU = health care resource utilization; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; ICS = inhaled corticosteroids; OCS = oral cortacosteroid; PPPY = per patient per year; SABA = short-acting beta-2 agonist; SD = standard deviation.