Observational Study of the Association of Fluticasone propionate/Salmeterol via a Single Device and Inhaled Corticosteroid Use in Children on Asthma Related Emergency Department and Hospitalization Visits
To assess the effect of fluticasone propionate/salmeterol administered in a single device (FSC) and inhaled corticosteroid (ICS) on asthma-related emergency department (ED) visits and hospitalizations over a 4.25 year period.
Methods
This was a retrospective observational analysis of the association between the use of FSC or ICS on asthma related ED visits in pediatric patients with asthma identified from a claims database of >45 US health plans representing 58.5M covered lives from March 1, 2002 to May 31, 2006. Study subjects included those with diagnosis of asthma (ICD-9, 493.xx), age 4-11 yrs, and dispensing of FSC or ICS (not both). Patients with ≥12 month continuous enrollment in each year were included. This criterion had to be met in each year of observation. Asthma related ED and hospitalization events were assessed during each season (spring [March-May] summer [June-August], fall [September-November], winter [December-February]). Total person seasons were calculated and a seasonally weighted mean ED and hospitalization rate per 1000 persons was determined for each cohort. Bivariate analysis was used to determine differences across cohorts.
Results
751,001 person seasons were identified, 185,836 for FSC and 565,165 for ICS. Asthma related ED event rates (41.4 vs 46.8) and hospitalization event rates (8.0 vs 11.0) were significantly lower (p < 0.001) for the FSC treated group compared to the ICS treated group over the 4.25 year period.
Conclusions
Use of FSC in this pediatric asthma cohort was associated with lower asthma related ED visits and asthma related hospitalizations compared to the use of ICS.
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