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Journal Information
Vol. 34. Issue 6.
Pages 301-307 (November - December 2019)
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Vol. 34. Issue 6.
Pages 301-307 (November - December 2019)
Original Article
DOI: 10.1016/j.jhqr.2019.06.007
Effects of medication adherence on healthcare services use among asthma patients
Efectos de la adherencia a la medicación en el uso de los servicios sanitarios entre los pacientes de asma
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A. Nittalaa, I. Nahmensa,
Corresponding author
nahmens@lsu.edu

Corresponding author.
, L. Ikumaa, D. Thomasb
a Louisiana State University, Baton Rouge, LA, United States
b Children's Hospital New Orleans, Louisiana, United States
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Tables (3)
Table 1. Patient demographics of asthma patients (n=687).
Table 2. Description of patients requiring inpatient, emergency department, office visits, 30-day or 90-day readmissions within the total study population.
Table 3. Correlation matrix for emergency, inpatient admits, 30- and 90-day readmissions and control & rescue medication adherence for asthma patients (n=687).
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Abstract
Introduction and objectives

Medication adherence is an important indicator of quality in healthcare, and non-adherence is associated with increased healthcare costs, hospital admissions, re-admissions, and decline in health outcomes. Despite the availability of medication to control and avoid adverse health outcomes, adherence to medications among asthma patients varies between 40% and 60%. The objective of this study is to evaluate the effects of asthma medication adherence on healthcare services.

Material and methods

This cross-sectional study is based on insurance claims data for Medicaid patients primarily diagnosed with asthma during 2015–2016. A regression analysis was performed to examine the relationship between control and rescue medication adherence with healthcare use (hospital admissions and re-admissions, clinic visits, and emergency department visits), as well as patient demographics (age, gender, and estimated income).

Results

This study found a control medication adherence of 82%. Patients with high rescue medication adherence had fewer emergency department visits (p=.0004) and inpatient admissions (p=.0303). Patients with more than 4 clinic visits had higher rescue medication adherence. Older and low-income patients had higher 30-day re-admissions. Males and low-income patients had more emergency visits.

Conclusions

These results provide evidence that certain populations (older, low-income, and male) may benefit from additional education on monitoring and controlling asthma. This may reduce costlier healthcare services use in favor of less expensive physician visits and education programs.

Keywords:
Medication adherence
Hospital use
Asthma patients
Resumen
Introducción y objetivos

La adherencia a la medicación es un indicador importante de la calidad de la atención sanitaria, asociándose la no adherencia al incremento de los costes sanitarios, los ingresos hospitalarios, los re-ingresos, y el descenso de los resultados médicos. A pesar de la disponibilidad de la medicación para controlar y evitar los resultados médicos adversos, la adherencia a la medicación entre los pacientes de asma oscila entre el 40 y el 60%. El objetivo de este estudio es evaluar los efectos de la adherencia a la medicación para el asma en los servicios sanitarios.

Material y métodos

Este estudio transversal se basa en los datos de las reclamaciones de seguros para pacientes de Medicaid con diagnóstico principal de asma durante el periodo 2015-2016. Se realizó un análisis de regresión para examinar la relación entre la adherencia a la medicación, de rescate y de control, y el uso sanitario (ingresos y re-ingresos hospitalarios, visitas clínicas, y visitas al servicio de urgencias), así como los datos demográficos de los pacientes (edad, sexo, e ingresos estimados).

Resultados

Este estudio encontró una adherencia a la medicación de control del 82%. Los pacientes con una alta adherencia a la medicación de rescate reflejaron una tasa menor de visitas al servicio de urgencias (p=0,0004) e ingresos hospitalarios (p=0,0303). Los pacientes con más de 4 visitas clínicas tuvieron mayor adherencia a la medicación de rescate. Los pacientes mayores y con rentas bajas reflejaron una tasa superior de re-ingresos a los 30 días. Los pacientes varones y con rentas bajas reflejaron una tasa superior de visitas al servicio de urgencias.

Conclusiones

Estos resultados aportan evidencia de que ciertas poblaciones (pacientes mayores, con rentas bajas, y varones) pueden beneficiarse de una formación adicional sobre supervisión y control del asma. Esto podría reducir el uso de los servicios sanitarios costosos, en favor de visitas médicas más económicas y programas educativos.

Palabras clave:
Adherencia a la medicación
Uso hospitalario
Pacientes de asma

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