Date of Award

2005

Degree Type

Dissertation

First Advisor

Cynthia Willey-Temkin

Abstract

Study. Prescribing patterns found in asthma patients compared to those patterns delineated in non-asthma patients. Background. Asthma is a chronic inflammatory disease of the airways characterized by inflammation as well as airway constriction. NIH guidelines recommend treatment of moderate to severe asthma with both preventive anti-inflammatory medication (inhaled corticosteroids) as well as a bronchodilator (beta 2 agonist) for quick relief of episodic symptoms (i.e., rescue medication). However, inhaled beta2-agonists are recommended for use in all types and classifications of asthma to provide prompt relief of airflow obstruction. The purpose of this study is to describe the pattern of prescribing inhaled bronchodilators for patients diagnosed with asthma and subsequently measure the influence of this prescribing in relationship to a number of selected independent variables. Main objective measure. The main study objective is to determine how many asthma patients are prescribed quick relief or immediate acting medication (i.e. an inhaled bronchodilator) and the association to a number of independent variables after controlling for possible confounders. The data collected from the study does support the idea that there is a relationship between the prescribing of an inhaled beta-2 agonist and gender, age, as well as, the socioeconomic status of the asthma patient. The analysis showed an association of prescribing an inhaled beta2-agonist with race/ethnicity, confounded by disease severity. Certainly, it would be expected that, based on current therapeutic asthma medication prescribing guidelines, the percentage of asthmatics prescribed an inhaled beta2-agonist should be much higher than what is reported in our study. There seems to be a difference between the percentage of asthma patients who experience constant episodes of wheezing and those patients who are prescribed an inhaled beta2-agonist. More importantly, different socioeconomic groups have been prescribed inhaled beta2-agonists in glaringly disproportionate frequencies. The findings derived from this study provide insight to physicians and other health care professionals who should be more mindful of their own adherence to recommended therapeutic guidelines irregardless of a patient's socioeconomic status or gender. (Abstract shortened by UMI.)

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