Healthcare Resource Utilization Associated with Intermittent Oral Corticosteroid Prescribing Patterns in Asthma

Trung Tran, Heath Heatley, Arnaud Bourdin (), Andrew Menzies-Gow, David Jackson, Ekaterina Maslova, Jatin Chapaneri, William Henley, Victoria Carter, Jeffrey Shi Kai Chan, Cono Ariti, John Haughney and David Price
Additional contact information
Trung Tran: AstraZeneca
Heath Heatley: OPRI - Observational and pragmatic research institute
Arnaud Bourdin: PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - UM - Université de Montpellier, CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Andrew Menzies-Gow: King‘s College London, AstraZeneca [Cambridge, UK]
David Jackson: King‘s College London
Ekaterina Maslova: AstraZeneca [Cambridge, UK]
Jatin Chapaneri: AstraZeneca [Cambridge, UK]
William Henley: OPRI - Observational and pragmatic research institute, University of Exeter Medical School - University of Exeter
Victoria Carter: OPRI - Observational and pragmatic research institute
Jeffrey Shi Kai Chan: OPRI - Observational and pragmatic research institute
Cono Ariti: OPRI - Observational and pragmatic research institute
John Haughney: University of Aberdeen, NHSGGC - NHS Greater Glasgow & Clyde [Glasgow]
David Price: University of Aberdeen, OPRI - Observational and pragmatic research institute

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Abstract: Purpose: Oral corticosteroid (OCS) use for asthma is associated with considerable healthcare resource utilization (HCRU) and costs. However, no study has investigated this in relation to patterns of intermittent OCS prescription. Methods: This historical UK cohort study used primary care medical records, linked to Hospital Episode Statistics, from 2008 to 2019, of patients (≥ 4 years old) with asthma prescribed intermittent OCS. Patients were categorized by OCS prescribing pattern (one-off [single], less frequent [≥ 90-day gap] and frequent [< 90-day gap]) and matched 1:1 (by sex, age and index date) with people never prescribed OCS with/without asthma. HCRU (reported as episodes, except for length of hospital stay [days] and any prescription [records]) and associated costs were compared between intermittent OCS and non-OCS cohorts, and among intermittent OCS prescribing patterns. Results: Of 149,191 eligible patients, 50.3% had one-off, 27.4% less frequent, and 22.3% frequent intermittent OCS prescribing patterns. Annualized non-respiratory HCRU rates were greater in the intermittent OCS versus non-OCS cohorts for GP visits (5.93 vs 4.70 episodes, p < 0.0001), hospital admissions (0.24 vs 0.16 episodes, p < 0.0001), and length of stay (1.87 vs 1.58 days, p < 0.0001). In the intermittent OCS cohort, rates were highest in the frequent prescribing group for GP visits (7.49 episodes; p < 0.0001 vs one-off), length of stay (2.15 days; p < 0.0001) and any prescription including OCS (25.22 prescriptions; p < 0.0001). Mean per-patient non-respiratory related and all-cause HCRU-related costs were higher with intermittent OCS than no OCS (£ 3902 vs £ 2722 and £ 8623 vs £ 4929, respectively), as were mean annualized costs (£ 565 vs £ 313 and £ 1526 vs £ 634, respectively). A dose–response relationship existed; HCRU-related costs were highest in the frequent prescribing cohort (p < 0.0001). Conclusion: Intermittent OCS use and more frequent intermittent OCS prescription patterns were associated with increased HCRU and associated costs. Improved asthma management is needed to reduce reliance on intermittent OCS in primary care.

Keywords: asthma; costs; healthcare resource utilization; intermittent; oral corticosteroids (search for similar items in EconPapers)
Date: 2024
Note: View the original document on HAL open archive server: https://hal.science/hal-04626705v1
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Published in Journal of Asthma and Allergy, 2024, 17, pp.573-587. ⟨10.2147/JAA.S452305⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04626705

DOI: 10.2147/JAA.S452305

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