The risk of recurrent emergency department visits or hospitalization in asthmatic children given different asthma medications

Abstract

Study objectives: We confirm whether budesonide inhalation suspension (BIS; Pulmicort Respules) reduces risk of recurrent hospitalization or emergency department (ED) visits in asthmatic children. Methods: A managed care organization database (PHARMetrics Patient-Centric database) was used to identify children aged 8 years or younger and with an asthma diagnosis and asthma-related hospitalization or ED visit (July 2000 to June 2002). We used asthma-related prescription claims during the first 30 days after hospitalization or ED visit to form the major comparison groups and calculated relative risk of hospitalization or ED visit for days 31 to 180 (Cox proportional hazards regression, covariates of age, sex, index event [ED visit/hospitalization], past and current asthma medications). Results: The index event was an ED visit for 79% of patients and hospitalization for 21% (N=10,176). Over the next 6 months, 13% of patients had another asthma-related ED visit or hospitalization. After adjustment for 12 factors, BIS patients had a 29% lower risk for subsequent hospitalization or ED visit versus those without BIS. Conclusion: BIS use in asthmatic children demonstrated significant effectiveness in preventing recurrent ED visits or hospitalizations.Table, abstract 121.CovariateNo. With CharacteristicHazards Ratio95% CIAge10,1760.95 ∗ 0.92–0.98Female sex3,4811.010.90–1.13Total number preindex SABA10,1761.06 ∗ 1.02–1.11Total number preindex OCS10,1761.24 ∗ 1.16–1.32Total number preindex controllers10,1760.970.93–1.01Hospitalization as index event2,1550.86 ∗ 0.75–0.99SABA4,8260.950.84–1.07OCS5,3581.23 ∗ 1.09–1.38BIS8190.71 ∗ 0.57–0.89ICS (excluding BIS)9180.980.81–1.19Leukotriene modifiers9140.990.81–1.21Mast cell stabilizers6391.54 ∗ 1.28–1.86Long-acting β 2 -agonists990.900.49–1.66 CI, Confidence interval; ICS, inhaled corticosteroid; OCS, oral corticosteroid; SABA, short-acting β 2 -agonist.∗P