Abstract
Background: Using real-life databases to compare asthma treatments requires composite proxies for asthma control.
Methods: Observational study using the US Ingenix Normative Healthcare Database to compare asthma outcomes between matched patients either initiating or increasing inhaled corticosteroid (ICS) therapy as fluticasone propionate (FP) or extra-fine hydrofluoroalkane beclomethasone dipropionate (EF HFA-BDP). Literature-based a priori-defined composites were developed and evaluated over 1yr, including: markers of emergency healthcare use for asthma and lower respiratory tract infections; use of oral steroids and reliever therapy; increased maintenance therapy, and controller-reliever ratio. Medication possession ratio (MPR) was calculated to assess adherence.
Results:
Conclusion: While the proportion of patients achieving asthma control varies according to the considered criterion, data consistently show similar or better outcomes for EF HFA-BDP despite a significantly lower ICS daily dose and similar MPR. Using multiple composite measures to evaluate comparative effectiveness reinforces confidence in study findings.
- © 2011 ERS