@article {Sullivan:2019:1088-5412:221,
title = "Medication use and indicators of poor asthma control in patients with and without allergies",
journal = "Allergy and Asthma Proceedings",
parent_itemid = "infobike://ocean/aap",
publishercode ="ocean",
year = "2019",
volume = "40",
number = "4",
publication date ="2019-07-01T00:00:00",
pages = "221-229",
itemtype = "ARTICLE",
issn = "1088-5412",
eissn = "1539-6304",
url = "https://www.ingentaconnect.com/content/ocean/aap/2019/00000040/00000004/art00003",
doi = "doi:10.2500/aap.2019.40.4226",
keyword = "allergic, medication use, persistent, Asthma Control Questionnaire (ACQ), real-world, atopic, asthma control, non-allergic, Asthma, allergic comorbidity",
author = "Sullivan, Patrick W. and Lanz, Miguel J. and Ghushchyan, Vahram H. and Kavati, Abhishek and LeCocq, Jason and Ortiz, Benjamin and Maselli, Diego J.",
abstract = "
Background:
Approximately two-thirds of people with asthma have some evidence of allergy; their condition differs from nonallergic asthma in terms of predominant symptoms and clinical outcomes. 
Objective:
To compare asthma control and medication use among
patients with persistent asthma with evidence of allergy (PA-EA) and patients with persistent asthma with no evidence of allergy (PA-NEA). 
Methods:
A retrospective analysis of survey responses and medication claims data from the Observational Study of Asthma Control and
Outcomes study, a prospective survey linked to retrospective claims-based analysis of patients ages 12 years with persistent asthma in a U.S. health maintenance organization. Evidence of allergy was defined as both a positive response to a survey question about hay fever and/or seasonal
allergies and one or more medical diagnostic codes for atopic conditions. Regression models were used to compare asthma control (Asthma Control Questionnaire [ACQ] scores) and asthma medication use between PA-EA and PA-NEA. 
Results:
Adjusted data showed that, versus the
patients with PA-NEA (n = 312), patients with PA-EA (n = 971) had higher (worse) 5-item and 6-item ACQ (ACQ-5 and ACQ-6) scores (by 0.34 [95% confidence interval {CI}, 0.240.44]; and 0.31 [95% CI, 0.210.40], respectively), were more likely to have poorly controlled asthma (ACQ-5
score 1.5: odds ratio 3.37 [95% CI, 2.075.50]; ACQ-6 score 1.5: odds ratio 3.46 [95% CI, 2.135.62]) and less likely to have well-controlled asthma (ACQ-5 score 0.75: odds ratio 0.21 [95% CI, 0.130.34]; ACQ-6 score 0.75: odds ratio 0.21 [95% CI, 0.130.35]).
Patients with PA-EA also had greater asthma medication use, most notably 2.5 times more prescriptions of high-dose inhaled corticosteroid in a 4-month period (95% CI, 1.215.16) and 16.15 times higher odds of chronic oral corticosteroid use (95% CI, 1.50174.09) versus PA-NEA.
Conclusion:
The patients with PA-EA versus PA-NEA had worse asthma control and greater medication use. These patients may need more vigilant clinical oversight and treatment management to ensure adequate asthma control.",
}