Jonathan Davitte, Bailey DeBarmore, David Hinds, Shiyuan Zhang, Jessica Chao, Leah Sansbury
{"title":"在Practice Fusion的电子病历研究数据库中治疗的美国哮喘患者的哮喘控制。","authors":"Jonathan Davitte, Bailey DeBarmore, David Hinds, Shiyuan Zhang, Jessica Chao, Leah Sansbury","doi":"10.1038/s41533-023-00338-7","DOIUrl":null,"url":null,"abstract":"<p><p>This study investigated burden of 'not well-controlled' asthma, overall and by Global Initiative for Asthma (GINA) Step, among treated asthma patients in Practice Fusion's research database. Asthma control (Asthma Control Test [ACT]) was stratified by GINA Step; prevalence ratios were estimated using Poisson regression with robust variance controlled for confounders. ACT scores ≤19 reflect not well-controlled; >19 reflect 'well-controlled' asthma. Of 15,579 patients, 30% had not well-controlled asthma at index date. The proportion of patients with not well-controlled asthma increased from GINA Step 1 (29%) to Step 5 (45%). Compared with Step 1, the proportion of patients with not well-controlled asthma was 0.87-times lower in Step 2, 1.10-times greater in Step 4, and 1.37-times greater in Step 5. Results suggest that despite available treatments, patients remain symptomatic across GINA Steps in real-world primary care and specialist outpatient practices, with incremental disease burden and unmet medical need in these populations.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"33 1","pages":"17"},"PeriodicalIF":3.1000,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140050/pdf/","citationCount":"1","resultStr":"{\"title\":\"Asthma control among treated US asthma patients in Practice Fusion's electronic medical record research database.\",\"authors\":\"Jonathan Davitte, Bailey DeBarmore, David Hinds, Shiyuan Zhang, Jessica Chao, Leah Sansbury\",\"doi\":\"10.1038/s41533-023-00338-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This study investigated burden of 'not well-controlled' asthma, overall and by Global Initiative for Asthma (GINA) Step, among treated asthma patients in Practice Fusion's research database. Asthma control (Asthma Control Test [ACT]) was stratified by GINA Step; prevalence ratios were estimated using Poisson regression with robust variance controlled for confounders. ACT scores ≤19 reflect not well-controlled; >19 reflect 'well-controlled' asthma. Of 15,579 patients, 30% had not well-controlled asthma at index date. The proportion of patients with not well-controlled asthma increased from GINA Step 1 (29%) to Step 5 (45%). Compared with Step 1, the proportion of patients with not well-controlled asthma was 0.87-times lower in Step 2, 1.10-times greater in Step 4, and 1.37-times greater in Step 5. Results suggest that despite available treatments, patients remain symptomatic across GINA Steps in real-world primary care and specialist outpatient practices, with incremental disease burden and unmet medical need in these populations.</p>\",\"PeriodicalId\":19470,\"journal\":{\"name\":\"NPJ Primary Care Respiratory Medicine\",\"volume\":\"33 1\",\"pages\":\"17\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2023-04-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140050/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"NPJ Primary Care Respiratory Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41533-023-00338-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"NPJ Primary Care Respiratory Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41533-023-00338-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 1
摘要
本研究调查了在Practice Fusion的研究数据库中接受治疗的哮喘患者的总体和全球哮喘倡议(GINA)步骤中“控制不好”的哮喘负担。哮喘控制(Asthma control Test [ACT])采用GINA Step分层;使用泊松回归估计患病率,并控制混杂因素的鲁棒方差。ACT分数≤19反映控制不好;>19例为“控制良好”的哮喘。在15579例患者中,30%的患者在索引日期时哮喘没有得到很好的控制。未得到良好控制的哮喘患者比例从GINA第1步(29%)增加到第5步(45%)。与第1步相比,第2步哮喘控制不良的患者比例降低0.87倍,第4步降低1.10倍,第5步降低1.37倍。结果表明,尽管有可用的治疗方法,在现实世界的初级保健和专科门诊实践中,患者在GINA步骤中仍然有症状,这些人群的疾病负担增加,医疗需求未得到满足。
Asthma control among treated US asthma patients in Practice Fusion's electronic medical record research database.
This study investigated burden of 'not well-controlled' asthma, overall and by Global Initiative for Asthma (GINA) Step, among treated asthma patients in Practice Fusion's research database. Asthma control (Asthma Control Test [ACT]) was stratified by GINA Step; prevalence ratios were estimated using Poisson regression with robust variance controlled for confounders. ACT scores ≤19 reflect not well-controlled; >19 reflect 'well-controlled' asthma. Of 15,579 patients, 30% had not well-controlled asthma at index date. The proportion of patients with not well-controlled asthma increased from GINA Step 1 (29%) to Step 5 (45%). Compared with Step 1, the proportion of patients with not well-controlled asthma was 0.87-times lower in Step 2, 1.10-times greater in Step 4, and 1.37-times greater in Step 5. Results suggest that despite available treatments, patients remain symptomatic across GINA Steps in real-world primary care and specialist outpatient practices, with incremental disease burden and unmet medical need in these populations.
期刊介绍:
npj Primary Care Respiratory Medicine is an open access, online-only, multidisciplinary journal dedicated to publishing high-quality research in all areas of the primary care management of respiratory and respiratory-related allergic diseases. Papers published by the journal represent important advances of significance to specialists within the fields of primary care and respiratory medicine. We are particularly interested in receiving papers in relation to the following aspects of respiratory medicine, respiratory-related allergic diseases and tobacco control:
epidemiology
prevention
clinical care
service delivery and organisation of healthcare (including implementation science)
global health.