Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses
Abstract Background Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-022-02295-2 |
| _version_ | 1797958834993496064 |
|---|---|
| author | Carlos Almonacid Eunice Fitas Joaquín Sánchez-Covisa Héctor Gutiérrez Pablo Rebollo |
| author_facet | Carlos Almonacid Eunice Fitas Joaquín Sánchez-Covisa Héctor Gutiérrez Pablo Rebollo |
| author_sort | Carlos Almonacid |
| collection | DOAJ |
| description | Abstract Background Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. Methods This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 “asthma” and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled β2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. Results Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25–Pc75) since asthma diagnosis was 83.1 months (34.65–131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. Conclusions There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control. |
| first_indexed | 2024-04-11T00:25:30Z |
| format | Article |
| id | doaj.art-c9b6038283634999b47602408a0c697e |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-11T00:25:30Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-c9b6038283634999b47602408a0c697e2023-01-08T12:04:05ZengBMCBMC Pulmonary Medicine1471-24662023-01-012311910.1186/s12890-022-02295-2Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analysesCarlos Almonacid0Eunice Fitas1Joaquín Sánchez-Covisa2Héctor Gutiérrez3Pablo Rebollo4Pulmonology Unit, Complejo Hospitalario de ToledoAstraZeneca FarmacéuticaAstraZeneca FarmacéuticaIQVIA SpainIQVIA SpainAbstract Background Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. Methods This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 “asthma” and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled β2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. Results Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25–Pc75) since asthma diagnosis was 83.1 months (34.65–131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. Conclusions There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control.https://doi.org/10.1186/s12890-022-02295-2Severe asthmaOral corticosteroidsReal-world dataSpain |
| spellingShingle | Carlos Almonacid Eunice Fitas Joaquín Sánchez-Covisa Héctor Gutiérrez Pablo Rebollo Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses BMC Pulmonary Medicine Severe asthma Oral corticosteroids Real-world data Spain |
| title | Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses |
| title_full | Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses |
| title_fullStr | Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses |
| title_full_unstemmed | Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses |
| title_short | Geographical differences in the use of oral corticosteroids in patients with severe asthma in Spain: heat map based on existing databases analyses |
| title_sort | geographical differences in the use of oral corticosteroids in patients with severe asthma in spain heat map based on existing databases analyses |
| topic | Severe asthma Oral corticosteroids Real-world data Spain |
| url | https://doi.org/10.1186/s12890-022-02295-2 |
| work_keys_str_mv | AT carlosalmonacid geographicaldifferencesintheuseoforalcorticosteroidsinpatientswithsevereasthmainspainheatmapbasedonexistingdatabasesanalyses AT eunicefitas geographicaldifferencesintheuseoforalcorticosteroidsinpatientswithsevereasthmainspainheatmapbasedonexistingdatabasesanalyses AT joaquinsanchezcovisa geographicaldifferencesintheuseoforalcorticosteroidsinpatientswithsevereasthmainspainheatmapbasedonexistingdatabasesanalyses AT hectorgutierrez geographicaldifferencesintheuseoforalcorticosteroidsinpatientswithsevereasthmainspainheatmapbasedonexistingdatabasesanalyses AT pablorebollo geographicaldifferencesintheuseoforalcorticosteroidsinpatientswithsevereasthmainspainheatmapbasedonexistingdatabasesanalyses |