Continuity of Prescribers of Short-Acting Beta Agonists among Children with Asthma

Objective To determine whether short-acting β-agonist (SABA) prescriber continuity was associated with emergency department visits among children with asthma. Study design An analysis of Michigan Medicaid administrative claims (2004–2005) for children ages 5 to 18 with asthma. Logistic regression mo...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of pediatrics 2009-12, Vol.155 (6), p.788-794
Main Authors: Dombkowski, Kevin J., DrPH, MS, Harrison, Stephanie Roahen, PhD, MPH, Cohn, Lisa M., MS, Lewis, Toby C., MD, MPH, Clark, Sarah J., MPH
Format: Article
Language:English
Subjects:
Adolescent
Adrenergic beta-Agonists - administration & dosage
Asthma - drug therapy
Biological and medical sciences
Child
Child, Preschool
Chronic obstructive pulmonary disease, asthma
Continuity of Patient Care
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Emergency Service, Hospital - utilization
Female
General aspects
Humans
Logistic Models
Male
Medical sciences
Michigan
Pediatrics
Pneumology
Practice Patterns, Physicians' - utilization
Retrospective Studies
Risk Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To determine whether short-acting β-agonist (SABA) prescriber continuity was associated with emergency department visits among children with asthma. Study design An analysis of Michigan Medicaid administrative claims (2004–2005) for children ages 5 to 18 with asthma. Logistic regression models assessed the effect of SABA prescriber continuity (the number and site of prescribers) on emergency department visits, controlling for demographics, historical (2004) asthma use and SABA prescription frequency (2-5 low; ≥6 high). Results Most children had one SABA prescriber (62%); 13% had multiple prescribers in the same practice as the primary care provider and 25% had multiple prescribers in different practices. Children with multiple prescribers in different practices had increased odds of an emergency department visit compared with those with 1 prescriber, among those with high SABA prescription frequency (AOR: 2.7, 95% CI: 1.9, 3.9), as well as those with low prescription frequency (AOR: 1.7, 95% CI: 1.3, 2.2). Conclusions Children with discontinuity of SABA prescribers have an increased risk of asthma emergency department visits, irrespective of their SABA prescription frequency. Primary care providers may have difficulty identifying patients at high risk with asthma solely on the basis of SABAs prescribed within their own practices.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2009.06.033