Complications and Health Care Resource Utilization Associated with Systemic Corticosteroids in Children and Adolescents with Persistent Asthma.

Background: Limited comparative data are available on the impact of systemic corticosteroid (SCS) use in children and adolescents.

Objective: To determine if asthmatic children and adolescents treated with SCS have a higher likelihood of developing complications versus those not receiving SCS and to examine health care resource utilization (HCRU) in this population.

Methods: A retrospective study of data from children and adolescents with persistent asthma retrieved from the MarketScan database, a large US health claims data set, for the period 2000 to 2017 was performed.

Impact of allergies on health-related quality of life in patients with asthma.

To estimate the health-related quality of life (HRQoL) and health utilities among asthma patients with and without comorbid allergies in a managed care population. This was a retrospective analysis of patient survey responses and pharmacy claims from the Observational Study of Asthma Control and Outcomes (OSACO). Patients ≥12 years-old with persistent asthma received four identical surveys between April-2011 and December-2012.

Healthcare resource utilization, expenditures, and productivity in patients with asthma with and without allergies.

To compare healthcare resource utilization (HCRU), healthcare expenditures, and work productivity and activity impairment within a general asthma population with persistent asthma and evidence of allergy (PA-EA) and persistent asthma with no evidence of allergy (PA-NEA). We conducted a retrospective analysis of survey responses and claims from the Observational Study of Asthma Control and Outcomes (OSACO) study. Eligible patients with persistent asthma aged ≥12 years were sent four surveys over 15 months.

Medication use and indicators of poor asthma control in patients with and without allergies.

Approximately two-thirds of people with asthma have some evidence of allergy; their condition differs from nonallergic asthma in terms of predominant symptoms and clinical outcomes. To compare asthma control and medication use among patients with persistent asthma with evidence of allergy (PA-EA) and patients with persistent asthma with no evidence of allergy (PA-NEA). A retrospective analysis of survey responses and medication claims data from the Observational Study of Asthma Control and Outcomes study, a prospective survey linked to retrospective claims-based analysis of patients ages ≥ 12 years with persistent asthma in a U.

Association Between Pulmonary Function and Asthma Symptoms.

Background: FEV as a percentage of predicted (FEV%pred) is commonly measured in asthma clinical studies; however, reports vary on its association with asthma control instruments evaluating symptoms.

Objective: Assess the association between FEV%pred and Asthma Control Questionnaire (ACQ) scores in a managed-care population with persistent asthma.

Methods: Retrospective analysis of survey responses and spirometry results of patients (aged ≥12 years) with persistent asthma from the Observational Study of Asthma Control and Outcomes was done.

Estimating asthma control questionnaire (ACQ) scores from claims data.

Background: Asthma control is the main focus of treatment guidelines. Valid instruments such as the Asthma Control Questionnaire (ACQ) require prospective survey. These surveys may be challenging for large population health applications.

Oral corticosteroid exposure and adverse effects in asthmatic patients.

Background: Significant adverse effects (AEs) have been associated with continuous exposure to oral corticosteroids (OCSs). The potential association with intermittent exposure is unknown.

Objective: We sought to assess the association between OCSs and AEs based on the number of OCS prescriptions.

EQ-5D Scores for Diabetes-Related Comorbidities.

Background: A single-source catalogue of nationally representative EuroQol five-dimensional questionnaire (EQ-5D) scores for chronic conditions in the United States and the United Kingdom from the Medical Expenditure Panel Survey (MEPS) has been published and has been used extensively for public health and cost-effectiveness modeling.

Objectives: To estimate EQ-5D scores for diabetes-related chronic conditions that are consistent with the previous catalogue.

Methods: The MEPS is a nationally representative survey of the US civilian population.

Health-related quality of life associated with systemic corticosteroids.

Background: Systemic corticosteroids (SCS) are commonly used but are associated with adverse effects. Given their prevalent use, the potential impact of SCS use on health-related quality of life (HRQoL) is important to characterize.

Objective: To assess the HRQoL of patients taking SCS.

Exploring asthma control cutoffs and economic outcomes using the Asthma Control Questionnaire.

Background: Understanding the effect of worsening asthma control on expenditures and health resource utilization (HRU) is important.

Objective: To explore the association of economic outcomes with asthma control cutoffs and longitudinal changes on the Asthma Control Questionnaire 5 (ACQ-5).

Methods: The Observational Study of Asthma Control and Outcomes was a survey of patients with persistent asthma who were patients of Kaiser Colorado, including claims-based HRU.

Measurement of utility in asthma: evidence indicating that generic instruments may miss clinically important changes.

Background: Accurate assessment of preference-based health-related quality of life is important in determining the value of asthma interventions.

Objective: To examine the sensitivity and responsiveness of the EQ-5D and the AQL-5D to differences in asthma control measured by the Asthma Control Questionnaire (ACQ-5).

Methods: The Observational Study of Asthma Control and Outcomes was a prospective survey of persistent asthma patients ≥12 years old in Kaiser Colorado.

Measuring the cost of poor asthma control and exacerbations.

Background: Previous studies have shown an association between cost and poor asthma control. However, longitudinal studies of general populations are lacking.

Objective: To examine the cost of poor asthma control and exacerbations across a broad spectrum of asthma patients.

Outcomes before and after treatment escalation to Global Initiative for Asthma steps 4 and 5 in severe asthma.

Background: Little is known about health outcomes in severe asthma reflected by Global Initiative for Asthma steps 4 and 5.

Objective: To analyze control, risk, economic, and health resource use (HRU) outcomes associated with treatment escalation to Global Initiative for Asthma steps 4 and 5.

Methods: This was a before-vs-after retrospective cohort study of patients (12-75 years old) with asthma newly initiated to omalizumab, high-intensity corticosteroids (HICS; ≥1,000 μg/day of inhaled fluticasone equivalent or oral prednisone), or high-dose inhaled corticosteroid (HDICS; ≥500 to <1,000 μg/day of fluticasone equivalent) using 2002 to 2011 MarketScan data.

Characterizing the severe asthma population in the United States: claims-based analysis of three treatment cohorts in the year prior to treatment escalation.

Objectives: Little is known about the disposition of severe patients prior to treatment escalation. To classify patients by treatment step using pharmacy data and describe their economic and healthcare utilization, insurance status, and sociodemographic characteristics in the year prior to escalation to Global Initiative for Asthma (GINA) steps 4 and 5.

Methods: This was a retrospective claims cohort study of asthma patients (age 12-75 years) newly initiated on "stable therapy" (three consecutive months of therapy) with omalizumab, high intensity corticosteroids (HICS; ≥1000 µg/d inhaled fluticasone equivalent or oral prednisone), or high-dose inhaled corticosteroid (HDICS; ≥500-<1000 µg/d fluticasone equivalent) from 2002 to 2011.

The relationship between asthma, asthma control and economic outcomes in the United States.

Objective: Asthma, a serious chronic lung disease affecting approximately 26 million Americans, remains clinical and economic burdens on the healthcare system. Although associations between uncontrolled asthma and poor health outcomes is known, the extent of this impact of uncontrolled asthma on economic outcomes in the United States (US) is unknown. We sought to determine the relationship between asthma, asthma control and economic outcomes in the US.

Asthma control in the United States, 2008-2010: indicators of poor asthma control.

Background: An estimated 23 million Americans have asthma, of whom at least 12 million experience an asthma exacerbation every year. Clinical practice guidelines focus on asthma control, with an emphasis on reducing both impairment and risk.

Objective: We sought to explore broad patterns of asthma prevalence, self-reported medication use, and indicators of control in a nationally representative sample.

Asthma in USA: its impact on health-related quality of life.

Objectives: Given the growing prevalence of asthma in USA, it is important to understand its national burden from the patient's perspective. The objective of this research is to examine the national burden of asthma and poor asthma control on health function, health perception and preference-based health-related quality of life (HRQL).

Methods: The Medical Expenditure Panel Survey (MEPS), a nationally representative survey, was used to estimate the impact of asthma and indicators of poor asthma control on health function, self-rated health perception and preference-based HRQL using multivariate regression methods controlling for socioeconomic, clinical and demographic characteristics.

The impact of co-morbidity burden on preference-based health-related quality of life in the United States.

Background: Many statistical analyses, clinical trials and cost-utility analyses designed to measure the impact of a particular disease on utility scores often overlook the important influence of co-morbidity burden.

Objectives: This study aims to examine the impact of co-morbidity burden on EQ-5D index scores in a nationally representative sample of the US.

Methods: The pooled 2001 and 2003 Medical Expenditure Panel Survey was used.

The burden of adult asthma in the United States: evidence from the Medical Expenditure Panel Survey.

Background: It is important to have an accurate picture of the sources and extent of medical expenditures and productivity loss to understand the nature and scope of the burden of asthma in the United States (US).

Objective: The current study aims to provide recent nationally representative estimates of direct and productivity-related costs attributable to asthma in adults in the US.

Methods: The 2003 and 2005 Medical Expenditure Panel Surveys were used to estimate the effect of asthma on medical expenditures, use, productivity, and chronic comorbidity among adults (≥ 18 years).

The impact of obesity on diabetes, hyperlipidemia and hypertension in the United States.

Objective: The prevalence of obesity and associated cardiometabolic risk factors such as diabetes, hyperlipidemia and hypertension is increasing significantly for all demographic groups.

Research Design And Methods: The 2000 and 2002 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the U.S.