Treatment-related problems and their cost among patients hospitalised with asthma exacerbation

Abstract

Treatment-related problems (TRPs) are events associated with patients’ managements adversely affecting the patients’ optimum outcomes. Asthma is a common chronic condition characterised by acute episodes of exacerbation. In Jordan, data regarding TRPs in asthma exacerbations are lacking. This study aimed to identify/classify TRPs among patients hospitalised with asthma exacerbation in Jordan and to estimate their costs. A retrospective observational cohort study (Jan 2017–Jul 2021) was conducted in a tertiary centre in Jordan. TRPs were identified during hospitalisation and at discharge using a standardised classification tool and assessed for their severity. Potential cost savings (the extra cost of medication/procedure associated with TRPs) and potential cost avoidance (the cost avoidable by preventing TRPs and their associated adverse drug events) were investigated. A total of 494 cases were included in the study. A total of 3933 TRPs (2931 during hospitalisation; 1002 at discharge) were identified with a mean of 4.7 ± 2.2 and 2.0 ± 1.2 TRPs during hospitalisation and at discharge, respectively. ‘Unnecessary drug therapy’ (40.8%) and ‘ineffective/incomplete drug therapy’ (44.1%) were the most common TRPs during hospitalisation and at discharge, respectively. In 82% of the cases, systemic corticosteroids were administered for a longer period than recommended. Most of the TRPs were of moderate severity. Potential cost savings and cost avoidance were estimated to be USD 30 919.3 and USD 734 179.9 respectively, with a total cost of USD 766 046.8. The prevalence and cost of TRPs among asthma exacerbations are relatively high. Interventions to reduce such problems are necessary to avoid the negative clinical outcomes of TRPs and their economic burden on patients and healthcare systems.