Asthma care in clinical practice can be aided by tools that anticipate the probability of exacerbations. Existing solutions, however, need extra information from patients in addition to electronic medical records. Therefore, for a study, researchers sought to forecast asthma exacerbations in the following year based on historical adherence to asthma treatments utilizing electronically accessible data.
The retrospective cohort analysis included individuals with more than or equal to one hospitalization or more than or equal to two medical claims for asthma in Quebec administrative databases between 2002 and 2015. The date of the first asthma-related ambulatory visit on or after satisfying the operational criteria of asthma was designated as cohort entry (CE). In the year preceding CE, adherence to each controller drug and usage of each rescue medicine were assessed. The elastic-net regularised logistic regression method was used.
The average age of the 98,823 patients was 55.9 years, with 36.2% being men. The predicted area under the curve was 0.708. The use of long-acting anticholinergic or long-acting β2-agonists in the year preceding CE raised the risks of aggravation by 24% and 21%, respectively, in the model. Low and high adherence to controller drugs increased the likelihood of receiving rescue medication by 2% to 5% compared to those with medium adherence. Patients who had a projected risk of more than or equal to 0.20 were more likely to experience a subsequent exacerbation.
According to this risk prediction, asthma-related drug usage increases the chance of asthma exacerbation. In addition, among users of rescue drugs, a possible U-shaped association between adherence to controller medications and the probability of exacerbation was discovered.