Corticosteroid choice and clinical outcomes for asthma exacerbations in the primary care setting
An analysis of Colorado's All Payer Claims Database
Marion Ruth Sills, MD, MPH | Department of Pediatrics, School of Medicine Dec 5, 2020This secondary data analysis studied children ages 3-9 years with a primary care clinic visit for asthma and an associated oral corticosteroid (OCS) prescription fill during the study period 2/2013-3/2019. The primary outcome was subsequent ED visit or hospital admission for asthma within 2-14 days after the index clinic visit. Demographics and asthma health services characteristics were assessed. Multivariable logistic regression was used to estimate the association between type of OCS prescription filled within 1 day of the index clinic visit and the primary outcome.
There were 3236 index clinic visits for asthma for 1918 children during the study period. Sixty-two percent were male and 66% were 3-4 years old. Prednisone/prednisolone accounted for 84% of OCS prescriptions fills within 1 day of the index clinic visit. 1% required ED visits and 1% required hospital admission within 2-14 days. In multivariate analysis, there was no statistical association between type of OCS prescribed and the primary outcome: subsequent ED or inpatient visits.