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ASTHMA CONTROL AMONG INDIVIDUALS WITH AND WITHOUT COMORBID ALLERGIES
Abstracts: Distinguished Industry Oral Abstracts / Ann Allergy Asthma Immunol 121 (2018) S18−S21
D201 OBSERVATIONAL VIGNETTE STUDY TO EXAMINE PATIENT, HEALTHCARE PROVIDER, AND CAREGIVER PERCEIVED BURDEN OF ASTHMA-RELATED EXACERBATIONS C. Averell1, P. Johnson2, C. Bell1, J. White2, B. Essoi2, L. Nelsen3, 1. Research Triangle Park, NC; 2. Eden Prairie, MN; 3. Collegeville, PA Introduction: Little is known about how patients, caregivers and healthcare providers (HCPs) perceive the impact of asthma-related exacerbations. This study examined the burden of asthma-related exacerbations on patients’ lives from these different perspectives. Methods: Web-based surveys were administered to a US sample of adult asthma patients, caregivers, and HCPs. Participants reviewed six vignettes describing two hypothetical asthma patients (25-year-old, single, unemployed; or 45-year-old, married, employed) experiencing mild, moderate, or severe exacerbations and rated the impact on eight measures: EuroQOL-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), sleep, household costs, and medical costs. The proportions reporting “problems”, “impact”, or “burden” for each measure were calculated for each vignette; and patient responses were compared to caregiver and HCP responses. Results: 302 asthma patients, 300 caregivers, and 300 HCPs completed the survey. Table 1 shows characteristics of these groups. No differences were detected in the proportions of perceived problems/
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impact/burden between patients and caregivers. Compared to HCPs, a greater proportion of patients reported problems with pain/ discomfort related to mild and moderate exacerbations. HCPs were more likely to indicate sleep impact, mobility problems, and financial burden across all exacerbation severity levels; self-care problems with moderate and severe exacerbations; and problems with usual activities and anxiety/depression for severe exacerbations, as compared to patients. Conclusions: Patients and caregivers share similar views on the impact of asthma exacerbations, yet HCPs may be less aware of patients' concerns about pain and discomfort related to exacerbations. Recognizing distinctions in perceptions may be an important consideration for optimizing patient care.
D202 ASTHMA CONTROL AMONG INDIVIDUALS WITH AND WITHOUT COMORBID ALLERGIES B. Ortiz1,*, P. Sullivan2, M. Lanz3, V. Ghushchyan2, A. Kavati1, J. LeCocq1, D. Maselli4, 1. East Hanover, NJ; 2. Denver, CO; 3. Coral Gables, FL; 4. San Antonio, TX Introduction: The prevalence of allergic asthma (AA) among patients with asthma is significant. We evaluated the differences in asthma control in patients with asthma with and without comorbid allergies in a managed care population. Methods: A retrospective analysis of patient survey responses and pharmacy claims from the Observational Study of Asthma Control and Outcomes was performed. Patients aged ≥ 12 years with persistent asthma received 4 identical surveys over 15 months. Allergies were identified by a positive response to a survey question about hay fever/seasonal allergies and ≥ 1 diagnostic code (ICD-9) for atopic conditions. Asthma control was measured using the 5-, 6-, and 7-item Asthma Control Questionnaire (ACQ; item 7 adds provider-performed lung function testing). ACQ scores ≤ 0.75 indicate well-controlled asthma, and scores ≥ 1.5 indicate poorly controlled asthma. An adjusted random-effects generalized least squares regression was used for ACQ scores, and adjusted random-effects logistic regression was used for the analysis of ACQ scores ≤ 0.75 or ≥ 1.5. Results: In total, 2,681 patients with asthma were included in the study, of whom 971 had AA. Compared with asthmatic patients without comorbid allergies, patients with AA had: ACQ-5 and -6 scores that were higher/worse (0.339 and 0.305 points higher, respectively); lower odds (0.213 and 0.214, respectively) of having well-controlled asthma; and higher odds (3.374 and 3.458, respectively) of having poorly controlled asthma (Table). Conclusions: Patients with AA had higher odds of having poorly controlled asthma compared with asthmatic individuals without allergies. Patients with AA may need more vigilant clinical monitoring to ensure adequate asthma control. Comparison of ACQ score, and whether asthma is well-controlled or poorly controlled, in patients with AA vs those with asthma and no comorbid allergies.
D201 OBSERVATIONAL VIGNETTE STUDY TO EXAMINE PATIENT, HEALTHCARE PROVIDER, AND CAREGIVER PERCEIVED BURDEN OF ASTHMA-RELATED EXACERBATIONS C. Averell1, P. Johnson2, C. Bell1, J. White2, B. Essoi2, L. Nelsen3, 1. Research Triangle Park, NC; 2. Eden Prairie, MN; 3. Collegeville, PA Introduction: Little is known about how patients, caregivers and healthcare providers (HCPs) perceive the impact of asthma-related exacerbations. This study examined the burden of asthma-related exacerbations on patients’ lives from these different perspectives. Methods: Web-based surveys were administered to a US sample of adult asthma patients, caregivers, and HCPs. Participants reviewed six vignettes describing two hypothetical asthma patients (25-year-old, single, unemployed; or 45-year-old, married, employed) experiencing mild, moderate, or severe exacerbations and rated the impact on eight measures: EuroQOL-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), sleep, household costs, and medical costs. The proportions reporting “problems”, “impact”, or “burden” for each measure were calculated for each vignette; and patient responses were compared to caregiver and HCP responses. Results: 302 asthma patients, 300 caregivers, and 300 HCPs completed the survey. Table 1 shows characteristics of these groups. No differences were detected in the proportions of perceived problems/
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impact/burden between patients and caregivers. Compared to HCPs, a greater proportion of patients reported problems with pain/ discomfort related to mild and moderate exacerbations. HCPs were more likely to indicate sleep impact, mobility problems, and financial burden across all exacerbation severity levels; self-care problems with moderate and severe exacerbations; and problems with usual activities and anxiety/depression for severe exacerbations, as compared to patients. Conclusions: Patients and caregivers share similar views on the impact of asthma exacerbations, yet HCPs may be less aware of patients' concerns about pain and discomfort related to exacerbations. Recognizing distinctions in perceptions may be an important consideration for optimizing patient care.
D202 ASTHMA CONTROL AMONG INDIVIDUALS WITH AND WITHOUT COMORBID ALLERGIES B. Ortiz1,*, P. Sullivan2, M. Lanz3, V. Ghushchyan2, A. Kavati1, J. LeCocq1, D. Maselli4, 1. East Hanover, NJ; 2. Denver, CO; 3. Coral Gables, FL; 4. San Antonio, TX Introduction: The prevalence of allergic asthma (AA) among patients with asthma is significant. We evaluated the differences in asthma control in patients with asthma with and without comorbid allergies in a managed care population. Methods: A retrospective analysis of patient survey responses and pharmacy claims from the Observational Study of Asthma Control and Outcomes was performed. Patients aged ≥ 12 years with persistent asthma received 4 identical surveys over 15 months. Allergies were identified by a positive response to a survey question about hay fever/seasonal allergies and ≥ 1 diagnostic code (ICD-9) for atopic conditions. Asthma control was measured using the 5-, 6-, and 7-item Asthma Control Questionnaire (ACQ; item 7 adds provider-performed lung function testing). ACQ scores ≤ 0.75 indicate well-controlled asthma, and scores ≥ 1.5 indicate poorly controlled asthma. An adjusted random-effects generalized least squares regression was used for ACQ scores, and adjusted random-effects logistic regression was used for the analysis of ACQ scores ≤ 0.75 or ≥ 1.5. Results: In total, 2,681 patients with asthma were included in the study, of whom 971 had AA. Compared with asthmatic patients without comorbid allergies, patients with AA had: ACQ-5 and -6 scores that were higher/worse (0.339 and 0.305 points higher, respectively); lower odds (0.213 and 0.214, respectively) of having well-controlled asthma; and higher odds (3.374 and 3.458, respectively) of having poorly controlled asthma (Table). Conclusions: Patients with AA had higher odds of having poorly controlled asthma compared with asthmatic individuals without allergies. Patients with AA may need more vigilant clinical monitoring to ensure adequate asthma control. Comparison of ACQ score, and whether asthma is well-controlled or poorly controlled, in patients with AA vs those with asthma and no comorbid allergies.