Asthma, Rhinitis, Other Respiratory DiseasesNational trends in asthma visits and asthma pharmacotherapy, 1978-2002☆,☆☆
Section snippets
Methods
Data were extracted from the NDTI, a continuing physician survey conducted by IMS HEALTH (Plymouth Meeting, Pa). The NDTI provides nationally representative diagnostic and prescribing information on patients treated by office-based physicians in the continental United States. A random sample of office-based physicians stratified by specialty and geographic region is selected from the master lists of the American Medical Association (Chicago, Ill) and the American Osteopathic Association
Asthma visits
There was a doubling in the estimated national number of annual visits by patients diagnosed with asthma between 1978 (8.5 million visits) and 1990 (17.7 million visits; Fig 1). The number of asthma visits then stabilized at a mean of 16 million between 1991 and 2002. In
Discussion
Using the 1978-2002 NDTI data, this study documents substantial changes in the number of asthma visits and in asthma pharmacotherapy. Our data indicate that the number of annual asthma visits has remained relatively stable since 1991. There has been an increasing trend in the prescription of controller medications, particularly inhaled corticosteroids, and a decreasing trend in reliever medication use, particularly short-acting oral β2-agonists. These trends are congruent with consensus
Acknowledgements
IMS HEALTH provided the data used in the analysis.
References (29)
- et al.
Asthma management and morbidity in Australian general practice: the relationship between patient and doctor estimates
Respir Med
(1995) - et al.
Cross-sectional analysis of the relationship between national guideline recommended asthma drug therapy and emergency/hospital use within a managed care population
Ann Allergy Asthma Immunol
(1998) Perception of the role and potential side effects of inhaled corticosteroids among asthmatic patients
Chest
(1998)- et al.
Trends in asthma therapy in the United States: 1965-1992
Ann Allergy Asthma Immunol
(1996) - et al.
Trends in asthma and chronic obstructive pulmonary disease therapy in Canada, 1985 to 1990
J Allergy Clin Immunol
(1993) - et al.
Asthma drug therapy trends in the United States, 1972 to 1985
J Allergy Clin Immunol
(1987) - et al.
Should the corticosteroid to bronchodilator ratio be promoted as a quality prescribing marker?
Public Health
(1999) - et al.
Is the quality of asthma prescribing, as measured by the general practice ratio of corticosteroid to bronchodilator, associated with asthma morbidity?
J Clin Epidemiol
(2000) Surveillance for Asthma—United States, 1980-1999
MMWR Morb Mortal Wkly Rep
(2002)Epidemiologic trends
Evidence for the increase in asthma worldwide
Ciba Found Symp
Surveillance for Asthma—United States, 1960-1995
MMWR Morb Mortal Wkly Rep
Treatment of Medicaid patients with asthma: comparison with treatment guidelines using disease-based drug utilization review methodology
Ann Pharmacother
Clinical management of asthma in the 1990s. Current therapy and new directions
Drugs
Cited by (70)
Asthmatic patient's preferences regarding frequency of physician consultation
2021, Saudi Pharmaceutical JournalHas Asthma Medication Use Caught Up With the Evidence?: A 12-Year Population-Based Study of Trends
2017, ChestCitation Excerpt :Although there have been multiple studies on the outcomes associated with inappropriate use of reliever medications, there has been a scarcity of evidence on the extent and trends of the phenomenon. Stafford et al22 analyzed 25 years (1978-2002) of nationally representative data on prescribing patterns by office-based US physicians. SABA use increased until the late 1990s and declined only in the last 3 years of the study period.
Practice Variation in Management of Childhood Asthma Is Associated with Outcome Differences
2016, Journal of Allergy and Clinical Immunology: In PracticeA cluster-randomized trial shows telephone peer coaching for parents reduces children's asthma morbidity
2015, Journal of Allergy and Clinical Immunology
- ☆
Supported by a research grant from the Agency for Healthcare Research and Quality (AHRQ) (R01-HS013405).
- ☆☆
Reprint requests: Randall S. Stafford, MD, PhD, Stanford Center for Research in Disease Prevention, Stanford University, Palo Alto, CA 94304.