An Evaluation of the Association Between Health Care Utilization and Use of Salmeterol Among Subjects with Asthma

Persistent Link:
http://hdl.handle.net/10150/195099
Title:
An Evaluation of the Association Between Health Care Utilization and Use of Salmeterol Among Subjects with Asthma
Author:
Wang, Meng-Ting
Issue Date:
2006
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
OBJECTIVE: To evaluate whether the use of salmeterol is associated with an increased risk of an asthma-related hospitalization or emergency care among asthma patients. METHODS: The data for this study were extracted from the Medstat MarketScan® claims databases occurring between 01/01/00 and 12/31/01. A nested case-control study design was employed. A cohort representing asthma patients was identified in 2000. Among the study cohort, hospitalized cases were identified as those who had the firsttime asthma-related hospitalization in 2001, and were matched to select controls by age (± 5 years), sex, and the number of ambulatory visits for asthma (5:1 control to case ratio). A similar process was applied to evaluating an asthma-related emergency department (ED) visit. The odds of prior salmeterol exposure among cases compared to controls were estimated using conditional multiple logistic regressions. The covariates of interest comprised age, prior hospital admission or ED visit for asthma, number of canisters of inhaled short-acting β₂ agonists and use of other asthma medications. RESULTS: A total of 35,312 subjects were eligible to be the study cohort. In addition, 285 and 640 subjects were identified as hospitalized and ED cases, respectively. The non-significant association was found when the prior salmeterol exposure was treated as a dichotomized variable. However, it was found that one unit increase in the number of canisters of salmeterol was associated with a seven percent decrease in the risk of a hospital admission for asthma (p <0.001). Additionally, current use of salmeterol was associated with a 48 percent decrease in the risk of an asthma-related hospitalization (OR = 0.52; p <0.001). The protective effect of salmeterol did not exist for those with recent or past use of salmeterol. Similar findings were observed for the ED visit outcome. CONCLUSIONS: The use of salmeterol was not found to be associated with an increased risk of an asthma-related hospital admission or ED visit. Conversely, one unit increase in the number of canisters of salmeterol and current use of salmeterol, respectively, were found to decrease the risk in an asthma-related hospitalization or ED visit among asthma patients.
Type:
text; Electronic Dissertation
Keywords:
SALMETEROL; MATCHED CASE-CONTROL STUDY
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Pharmaceutical Sciences; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Malone, Daniel C.
Committee Chair:
Malone, Daniel C.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleAn Evaluation of the Association Between Health Care Utilization and Use of Salmeterol Among Subjects with Asthmaen_US
dc.creatorWang, Meng-Tingen_US
dc.contributor.authorWang, Meng-Tingen_US
dc.date.issued2006en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractOBJECTIVE: To evaluate whether the use of salmeterol is associated with an increased risk of an asthma-related hospitalization or emergency care among asthma patients. METHODS: The data for this study were extracted from the Medstat MarketScan® claims databases occurring between 01/01/00 and 12/31/01. A nested case-control study design was employed. A cohort representing asthma patients was identified in 2000. Among the study cohort, hospitalized cases were identified as those who had the firsttime asthma-related hospitalization in 2001, and were matched to select controls by age (± 5 years), sex, and the number of ambulatory visits for asthma (5:1 control to case ratio). A similar process was applied to evaluating an asthma-related emergency department (ED) visit. The odds of prior salmeterol exposure among cases compared to controls were estimated using conditional multiple logistic regressions. The covariates of interest comprised age, prior hospital admission or ED visit for asthma, number of canisters of inhaled short-acting β₂ agonists and use of other asthma medications. RESULTS: A total of 35,312 subjects were eligible to be the study cohort. In addition, 285 and 640 subjects were identified as hospitalized and ED cases, respectively. The non-significant association was found when the prior salmeterol exposure was treated as a dichotomized variable. However, it was found that one unit increase in the number of canisters of salmeterol was associated with a seven percent decrease in the risk of a hospital admission for asthma (p <0.001). Additionally, current use of salmeterol was associated with a 48 percent decrease in the risk of an asthma-related hospitalization (OR = 0.52; p <0.001). The protective effect of salmeterol did not exist for those with recent or past use of salmeterol. Similar findings were observed for the ED visit outcome. CONCLUSIONS: The use of salmeterol was not found to be associated with an increased risk of an asthma-related hospital admission or ED visit. Conversely, one unit increase in the number of canisters of salmeterol and current use of salmeterol, respectively, were found to decrease the risk in an asthma-related hospitalization or ED visit among asthma patients.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectSALMETEROLen_US
dc.subjectMATCHED CASE-CONTROL STUDYen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplinePharmaceutical Sciencesen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorMalone, Daniel C.en_US
dc.contributor.chairMalone, Daniel C.en_US
dc.contributor.committeememberSkrepnek, Grant H.en_US
dc.contributor.committeememberVogel, Ronald J.en_US
dc.contributor.committeememberHarris, Robin B.en_US
dc.contributor.committeememberSherrill, Duane L.en_US
dc.identifier.proquest1564en_US
dc.identifier.oclc137355937en_US
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