PRS56 PREDICTORS OF PSYCHOLOGICAL DISTRESS AND ITS INFLUENCE ON RELIEVER MEDICATION USE IN ASTHMA

Abstract

Asthma affects more than 300 million people worldwide and over 26 million people in the US. Incidence of psychological distress (PD) in asthma, a consequence of coexisting psychological comorbidities like anxiety and/or depression, is on the rise. The study aims to identify sociodemographic and other factors that are associated with PD and assess its impact specifically on reliever medication use in Asthma. A retrospective, cross-sectional research data, obtained from the Medical Expenditure Panel Survey (MEPS, 2013-2015) and consisted of a sample of 5307 community dwelling asthmatics. PD was identified by using Kessler-6 scale (a score of ≥ 13), a self-administered written questionnaire embedded in MEPS. Use of three or more canisters of quick relief inhalers was defined as overuse of relievers. A Chi-square analyses was performed to test association between PD and reliever use. A set of logistic regression (LR) analyses was performed to determine the predictors of PD as well as reliever overuse in asthmatics with PD. Compared to those without distress, a higher proportion of psychologically distressed asthmatics reported reliever overuse (2=310956.703, 23.3% vs 12.2%, p<0.0001). Female asthmatics were 32.3% more likely to have PD than males (OR=1.323, C.I=1.320-1.326, p<0.0001). The LR results revealed that female asthmatics within the PD group were more likely to overuse relievers than males (OR= 2.263, C.I= 2.255-2.2343, p<0.0001), and those with 12 years or more of education were less likely to overuse relievers compared to those with less education (OR=0.555, C.I=0.553-0.556, p<0.0001). A Phi correlation coefficient (rφ=–0.103) revealed a significant negative correlation between PD scores and reliever overuse. Comorbidity of PD in asthma is associated with over-utilization of reliever medications. Inappropriate medication use can affect treatment plan, compromise patient’s quality of life, and increase the overall cost of care in asthma.