PRS6 - Comparative Assessment of Asthma Control Outcomes Among Pediatric Asthma Patients: Learnings From Database Studies in The U.S and South Korea

Abstract

This study descriptively compares asthma control risk factors and outcomes observed in two recent observational studies in the US and South Korea. The US study, a cross-sectional pediatric asthma study (ages 6-17 years old) conducted using the Medical Expenditure Panel Survey (MEPS) database between 2007-2013, explored socio-demographics (SD), healthcare resource utilization (HRU), asthma control, and cost outcomes. The Korean study, a longitudinal cohort pediatric asthma study (ages 2-17 years old) using the Health Insurance Review and Assessment (HIRA) database between 2014-2016, compared patient demographics, clinical outcomes, HRU, medication utilization (adherence/persistence), asthma control and costs between patients initiated on low dose budesonide inhalation suspension (BIS) or montelukast (MON). The MEPS database is comprised of patient interview responses and utilization/expenditure data; the HIRA database consists of national insurance claims for covered healthcare utilization. Both studies explored exacerbation risk, acute HRU (hospitalization, ER visits, etc.), and rescue medication use as proxy measures of asthma control. Both studies demonstrated that there was poor utilization of asthma controller medications and an over-reliance on rescue inhalers. In the US study, only 19% of pediatric asthma patients used a daily controller medication for asthma but 59% experienced an exacerbation (self-reported) in the previous year. In the Korean study, treatment adherence as measured by percent of days covered (PDC) was very low in both cohorts (13.33% MON vs. 4.86% BIS), and patients in both cohorts were highly non-persistent (>80% non-persistency rate after 1 year), with > 80% of BIS and MON patients not in control over the 1 year post-index. Under-utilization of controller agents and an over-reliance on rescue medication use are major drivers for poor asthma control outcomes in both countries. Better asthma management education of providers, patients and parents should be explored in both countries.