TY - JOUR
T1 - German regional variation of acute and high oral corticosteroid use for asthma
AU - Nan, Cassandra
AU - Schmidt, Olaf
AU - Lindner, Robert
AU - Ilgin, Yasemin
AU - Schultz, Thomas
AU - Hinsch Gylvin, Lykke
AU - Bleecker, Eugene R.
N1 - Funding Information:
This study was funded by AstraZeneca. Editorial support was provided by Nate Connors, PhD, of Citrus Health Group (Lantana, FL, USA), and Michael A. Nissen, ELS, of AstraZeneca (Gaithersburg, MD, USA). Writing support was funded by AstraZeneca.
Funding Information:
This study was funded by AstraZeneca. Editorial support was provided by Nate Connors, PhD, of Citrus Health Group (Lantana, FL, USA), and Michael A. Nissen, ELS, of AstraZeneca (Gaithersburg, MD, USA). Writing support was funded by AstraZeneca.
Publisher Copyright:
© 2021 AstraZeneca. Published with license by Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Objective: : To improve understanding of real-world asthma treatment and inform physician education, we evaluated regional variation in asthma prevalence and oral corticosteroid (OCS) use across Germany. Methods: : We developed a machine learning gradient-boosted tree model with IMS® Disease Analyzer electronic medical records, which cover 3% of German patients. This model had a 91% accuracy in predicting the presence of asthma and chronic obstructive pulmonary disease. We applied the model to the IMS® Longitudinal Prescription database, with 82% national coverage, to classify patients receiving treatment for airflow obstruction from October 2017–September 2018 in 63 regions in Germany. Results: : Of 2.4 million individuals under statutory health insurance predicted to have asthma, 13.7%, 18.7%, 36.5%, 29.4%, and 1.7% received treatment classified as Global Initiative for Asthma (GINA) Steps 1, 2, 3, 4, and 5, respectively. Approximately 7–15% of those at GINA Steps 1–4 and 35% at Step 5 treatment received ≥1 acute OCS prescription (duration <10 days). Of patients receiving GINA Steps 1–4 and Step 5 treatments, 1–3% and 86%, respectively, received ≥1 high-dosage OCS prescription. Cumulative OCS dosage and percentages of patients receiving OCS differed substantially across regions, and regions with lower OCS use had greater use of biologic therapies. Conclusions: : Both acute and high OCS use varied regionally across Germany, with overall use suggesting patients are considerable risk of adverse effects and long-term health consequences. Supplemental data for this article can be accessed at publisher’s website.
AB - Objective: : To improve understanding of real-world asthma treatment and inform physician education, we evaluated regional variation in asthma prevalence and oral corticosteroid (OCS) use across Germany. Methods: : We developed a machine learning gradient-boosted tree model with IMS® Disease Analyzer electronic medical records, which cover 3% of German patients. This model had a 91% accuracy in predicting the presence of asthma and chronic obstructive pulmonary disease. We applied the model to the IMS® Longitudinal Prescription database, with 82% national coverage, to classify patients receiving treatment for airflow obstruction from October 2017–September 2018 in 63 regions in Germany. Results: : Of 2.4 million individuals under statutory health insurance predicted to have asthma, 13.7%, 18.7%, 36.5%, 29.4%, and 1.7% received treatment classified as Global Initiative for Asthma (GINA) Steps 1, 2, 3, 4, and 5, respectively. Approximately 7–15% of those at GINA Steps 1–4 and 35% at Step 5 treatment received ≥1 acute OCS prescription (duration <10 days). Of patients receiving GINA Steps 1–4 and Step 5 treatments, 1–3% and 86%, respectively, received ≥1 high-dosage OCS prescription. Cumulative OCS dosage and percentages of patients receiving OCS differed substantially across regions, and regions with lower OCS use had greater use of biologic therapies. Conclusions: : Both acute and high OCS use varied regionally across Germany, with overall use suggesting patients are considerable risk of adverse effects and long-term health consequences. Supplemental data for this article can be accessed at publisher’s website.
KW - Germany
KW - bronchial disease
KW - medical informatics
KW - obstructive lung disease
KW - resource allocation
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U2 - 10.1080/02770903.2021.1878532
DO - 10.1080/02770903.2021.1878532
M3 - Article
C2 - 33492176
AN - SCOPUS:85100843658
SN - 0277-0903
VL - 59
SP - 791
EP - 800
JO - Journal of Asthma
JF - Journal of Asthma
IS - 4
ER -