Medication Management for People with Asthma

Asthma is one of the most prevalent chronic diseases, becoming increasingly more commonplace over the past twenty years. In the United States, approximately 26 million people have asthma; 7.6% of adults (1 in 13) and 8.4 children (1 in 12) have asthma and it is responsible for over 3,615 deaths annually (Asthma and Allergy Foundation of America).  The morbidity and mortality rates continue to rise. The financial cost of asthma exceeds $81 billion every year and despite all the resources invested, asthma is responsible for over 3,500 deaths annually in the nation.

Pharmacologic therapy is used to prevent and control asthma symptoms, improve quality of life, reduce the frequency and severity of asthma exacerbations, and reverse airflow obstruction.  Medications for asthma are usually categorized into long-term controller medications used to achieve and maintain control of persistent asthma and quick-reliever medications used to treat acute symptoms and exacerbations. Medication adherence could ameliorate the severity of many asthma-related symptoms for children as well as adults.

HEDIS MY2023 

WHA annually measures and reports the percentage of members 5 to 64 years of age during the measurement year who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the treatment period. Two rates are reported:

1. The percentage of members who remained on an asthma controller medication for at least 50% of their treatment period.
2. The percentage of members who remained on an asthma controller medication for at least 75% of their treatment period.

The MY2023 Asthma Medication Management rates for 75% controller medication compliance show mixed results. For patients 5 to 85 years of age, the overall rate of compliance with controller medications increased 3.33 percentage points to 81.52%, and ranks in the NCQA national 33rd percentile. For children 5 to 11 years the rate improved, but is the lowest and ranks in the 66th percentile. For adolescents 12 to 18 years the rate decreased 5 percentage points and ranked in the 5th percentile.  For adults 19 to 50 years old, the rate improved and ranks in the 25th percentile. This shows opportunities for improvement for patients of all ages.

Health Disparities in Asthma:

The prevalence of asthma among Puerto Rican and non-Hispanic Black children (21.2% and 14.5%, respectively) is higher than among non-Hispanic White and Mexican American children (8.2% and 7.5%, respectively). Similarly, the prevalence of asthma is higher among individuals of low socioeconomic status. Asthma mortality rates are highest for adults, women, and African Americans. African Americans have a mortality rate twice as high as White Americans (21.8 vs 9.5 death rate per million).

Reference:

• Ebrahimabadi M, Rezaei K, Moini A, Fournier A, Abedi A. Infographics or video; which one is more effective in asthmatic patients' health? a randomized clinical trial. J Asthma. 2019 Dec;56(12):1306-1313.
  https://pubmed.ncbi.nlm.nih.gov/30395745/. (Retrieved August 29, 2024)
   
• National Center for Health Statistics. (2024). 2021 NHIS Adult Summary Health Statistics. U.S. Department of Health and Human Services. https://data.cdc.gov/d/25m4-6qqq. (Retrieved August 29, 2024)
   
• National Center for Health Statistics. (2024). 2021 NHIS Child Summary Health Statistics. U.S. Department of Health and Human Services. https://data.cdc.gov/d/wxz7-ekz9. (Retrieved August 29, 2024)
   
• Sandeep Sharma; Muhammad F. Hashmi; Rebanta K. Chakraborty. Asthma Medication. NIH National Library of Medicine. StatPearls Publishing. Jan 2023. https://www.ncbi.nlm.nih.gov/books/NBK531455/. (Retrieved August 29, 2024)