Prevalence of polypharmacy and associated adverse outcomes and risk factors among children with asthma in the USA: a cross-sectional study

Author:

Xie LuyuORCID,Gelfand Andrew,Murphy Caitlin C,Mathew M Sunil,Atem FolefacORCID,Delclos George L,Messiah SarahORCID

Abstract

ObjectiveTo estimate the prevalence of polypharmacy, identify risk factors and examine related adverse outcomes in the US children with asthma.Design, setting and participantsThis population-based, cross-sectional study included 1776 children with asthma from the 2011–2020 National Health and Nutrition Examination Surveys.ExposuresPolypharmacy is defined as taking ≥2 medications concurrently for ≥1 day over the past 30 days.Main outcomes and measures(1) Weighted prevalence estimates of polypharmacy in children with asthma; (2) asthma attacks and emergency department (ED) visits.ResultsThe estimated prevalence of polypharmacy in the US children with asthma was 33.49% (95% CI 31.81% to 35.17%). 15.53% (95% CI 14.31% to 16.75%), 12.63% (95% CI 11.37% to 13.88%) and 5.33% (95% CI) of participants were taking 2, 3–4, and 5 prescription medications, respectively. In addition to asthma medications, the most common sources of polypharmacy included antihistamines (20.17%, 95% CI 16.07% to 24.28%), glucocorticoids (16.67%, 95% 12.57% to 20.78%), and anti-infectives (14.28%, 95% CI 10.29 to 18.28). Risk factors for the increased number of medications included age 5–11 years old (vs 1–4 years: adjusted incidence rate ratio (aIRR) 1.38, 95% CI 1.10 to 1.72), fair-to-poor health (vs excellent or very good: aIRR 1.42, 95% CI 1.05 to 1.92), or ≥6 healthcare utilisation encounters over the last year (vs 0–5 encounters: aIRR 1.45, 95% CI 1.26 to 1.66). Polypharmacy increased the odds of an asthma attack (adjusted OR (aOR) 2.80, 95% CI 1.99 to 3.93) and ED visit (aOR 2.41, 95%1.59–3.63) after adjusting for demographics, insurance and health status.ConclusionsEvery one in three US children with asthma experienced polypharmacy. Although it may reflect the treatment guidelines that various asthma medications are needed for maintenance therapy, our results suggested that polypharmacy increased the odds of asthma attacks or ED visits. This may be due to the concurrent use with other non-asthma medications indicating that there is an opportunity to improve medication management in children with asthma.

Publisher

BMJ

Subject

General Medicine

Reference40 articles.

1. CDC . Most recent national asthma data.. Available: https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm [Accessed June 17, 2021].

2. The Economic Burden of Asthma in the United States, 2008–2013

3. GINA Main Report - Global Initiative for Asthma - GINA. Global Initiative for Asthma - GINA;Published March,2021

4. Comorbidities of asthma in U;Mirabelli;S. children. Respir Med,2016

5. Xie L , Gelfand A , Delclos GL , et al . Kohl Hw 3rd, Messiah Se. estimated prevalence of asthma in US children with developmental disabilities. JAMA Netw Open;2020;3:e207728.

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Trends in Coprescription Among Taiwanese Children from 2002 to 2012;Journal of Multidisciplinary Healthcare;2023-12

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3