A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist
Soichiro Hozawa,1 Keita Ono,2 Naoyuki Makita,3 Hitomi Uchimura,3 Yoshifumi Arita,3 Takehiro Hirai,2 Naoki Tashiro3 1Hiroshima Allergy and Respiratory Clinic, Hiroshima, Japan; 2AstraZeneca K.K., Tokyo, Japan; 3AstraZeneca K.K., Osaka, JapanCorrespondence: Soichiro Hozawa, Hiroshima Allergy and Respi...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-01-01
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| Series: | Journal of Asthma and Allergy |
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| Online Access: | https://www.dovepress.com/a-retrospective-claims-database-study-to-clarify-treatment-reality-of--peer-reviewed-fulltext-article-JAA |
| _version_ | 1797351813321588736 |
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| author | Hozawa S Ono K Makita N Uchimura H Arita Y Hirai T Tashiro N |
| author_facet | Hozawa S Ono K Makita N Uchimura H Arita Y Hirai T Tashiro N |
| author_sort | Hozawa S |
| collection | DOAJ |
| description | Soichiro Hozawa,1 Keita Ono,2 Naoyuki Makita,3 Hitomi Uchimura,3 Yoshifumi Arita,3 Takehiro Hirai,2 Naoki Tashiro3 1Hiroshima Allergy and Respiratory Clinic, Hiroshima, Japan; 2AstraZeneca K.K., Tokyo, Japan; 3AstraZeneca K.K., Osaka, JapanCorrespondence: Soichiro Hozawa, Hiroshima Allergy and Respiratory Clinic, 6F, 1-9-28 Hikari-machi, Higashi-ku, Hiroshima, 732-0052, Japan, Tel +81-82-568-1167, Fax +81-82-568-1239, Email hozawa@vesta.ocn.ne.jpPurpose: Japanese guidelines recommend that patients with uncontrolled asthma be referred by non-specialists to specialists (allergists and/or pulmonologists). This study investigated the reality of clinical practice in asthma patients referred to specialists in Japan.Patients and Methods: This was a retrospective, observational cohort study of asthma patients in a health insurance claim database (Cross Fact) referred from facilities with non-specialists to those with specialists from January 2016 to December 2018. The referred asthma patients were defined as patients with ≥ 4 inhaled corticosteroid (ICS)-containing prescriptions during a 1-year baseline period, with an asthma diagnosis, and who had visited a facility with specialists. Asthma exacerbation, maintenance treatment, laboratory tests, and medical procedures before and after referral were analyzed.Results: Data for 2135 patients were extracted, of which 420 with referral codes were analyzed. The proportion of patients with asthma exacerbations was 50.2% (95% confidence interval [CI]: 45.4– 55.1%) before referral and 37.4% (95% CI: 32.7– 42.2%) after, a significant decrease (P< 0.001; McNemar test). The proportions of patients prescribed ICS alone, long-acting beta-agonists (LABA), and ICS/LABA were lower after referral than before, but the proportions of patients prescribed long-acting muscarinic antagonists (LAMA), ICS/LABA/LAMA, and biologics increased after referral. More asthma-related laboratory tests were performed after referral, and spirometry incidence increased from 16.4% before referral to 51.4% after referral.Conclusion: This study shows a decrease in asthma exacerbations, change in asthma treatments, and increase in laboratory tests after referral to a specialist, suggesting that referrals to specialists lead to better management of asthma.Keywords: asthma, database, referral, specialist, symptom exacerbation |
| first_indexed | 2024-03-08T13:05:55Z |
| format | Article |
| id | doaj.art-25a9d78764214a3aa3be00a1cb8189f0 |
| institution | Directory Open Access Journal |
| issn | 1178-6965 |
| language | English |
| last_indexed | 2024-03-08T13:05:55Z |
| publishDate | 2024-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Asthma and Allergy |
| spelling | doaj.art-25a9d78764214a3aa3be00a1cb8189f02024-01-18T18:05:05ZengDove Medical PressJournal of Asthma and Allergy1178-69652024-01-01Volume 1791989788A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a SpecialistHozawa SOno KMakita NUchimura HArita YHirai TTashiro NSoichiro Hozawa,1 Keita Ono,2 Naoyuki Makita,3 Hitomi Uchimura,3 Yoshifumi Arita,3 Takehiro Hirai,2 Naoki Tashiro3 1Hiroshima Allergy and Respiratory Clinic, Hiroshima, Japan; 2AstraZeneca K.K., Tokyo, Japan; 3AstraZeneca K.K., Osaka, JapanCorrespondence: Soichiro Hozawa, Hiroshima Allergy and Respiratory Clinic, 6F, 1-9-28 Hikari-machi, Higashi-ku, Hiroshima, 732-0052, Japan, Tel +81-82-568-1167, Fax +81-82-568-1239, Email hozawa@vesta.ocn.ne.jpPurpose: Japanese guidelines recommend that patients with uncontrolled asthma be referred by non-specialists to specialists (allergists and/or pulmonologists). This study investigated the reality of clinical practice in asthma patients referred to specialists in Japan.Patients and Methods: This was a retrospective, observational cohort study of asthma patients in a health insurance claim database (Cross Fact) referred from facilities with non-specialists to those with specialists from January 2016 to December 2018. The referred asthma patients were defined as patients with ≥ 4 inhaled corticosteroid (ICS)-containing prescriptions during a 1-year baseline period, with an asthma diagnosis, and who had visited a facility with specialists. Asthma exacerbation, maintenance treatment, laboratory tests, and medical procedures before and after referral were analyzed.Results: Data for 2135 patients were extracted, of which 420 with referral codes were analyzed. The proportion of patients with asthma exacerbations was 50.2% (95% confidence interval [CI]: 45.4– 55.1%) before referral and 37.4% (95% CI: 32.7– 42.2%) after, a significant decrease (P< 0.001; McNemar test). The proportions of patients prescribed ICS alone, long-acting beta-agonists (LABA), and ICS/LABA were lower after referral than before, but the proportions of patients prescribed long-acting muscarinic antagonists (LAMA), ICS/LABA/LAMA, and biologics increased after referral. More asthma-related laboratory tests were performed after referral, and spirometry incidence increased from 16.4% before referral to 51.4% after referral.Conclusion: This study shows a decrease in asthma exacerbations, change in asthma treatments, and increase in laboratory tests after referral to a specialist, suggesting that referrals to specialists lead to better management of asthma.Keywords: asthma, database, referral, specialist, symptom exacerbationhttps://www.dovepress.com/a-retrospective-claims-database-study-to-clarify-treatment-reality-of--peer-reviewed-fulltext-article-JAAasthmadatabasereferralspecialistsymptom exacerbation |
| spellingShingle | Hozawa S Ono K Makita N Uchimura H Arita Y Hirai T Tashiro N A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist Journal of Asthma and Allergy asthma database referral specialist symptom exacerbation |
| title | A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist |
| title_full | A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist |
| title_fullStr | A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist |
| title_full_unstemmed | A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist |
| title_short | A Retrospective Claims Database Study to Clarify Treatment Reality of Asthma Patients Before and After Referral to a Specialist |
| title_sort | retrospective claims database study to clarify treatment reality of asthma patients before and after referral to a specialist |
| topic | asthma database referral specialist symptom exacerbation |
| url | https://www.dovepress.com/a-retrospective-claims-database-study-to-clarify-treatment-reality-of--peer-reviewed-fulltext-article-JAA |
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