Methods: Historical cohort study of UK patients ≥4 years old using the Clinical Practice Research Datalink (2008–2019). Patients receiving intermittent OCS were categorised by OCS prescribing pattern based on prescription gaps (only 1 [once-only], >1 with any gaps >90-days but no gaps <90-days [less frequent], and >1 with <90-day gap(s) [frequent]) and indexed on the first intermittent OCS prescription within 3 months of an asthma-related event; OCS-naïve patients matched on gender, age, and index date served as controls. We excluded patients with long-term OCS use, chronic conditions treated with OCS, or adverse events pre-index. HCRU (general practitioner [GP], outpatient and Accident and Emergency [A&E] visits, hospitalisations, admissions, and prescriptions) and cost were compared for OCS and non-OCS use (Mann-Whitney test) and for intermittent OCS use patterns (Chi-squared test). Cost sources were Personal Social Services Research Unit 2020 for GP and outpatient visits and hospitalisations; NHS National Cost Collection 2019/20 for A&E visits; Prescription Cost Analysis 2018 for prescriptions.
Results: Of 763,136 patients with asthma receiving an OCS prescription, 149,191 met eligibility criteria (52.6% female, mean age 38.7). 50.3%, 27.4%, and 22.3% had once-only, less frequent, and frequent pattern of OCS use during follow-up, respectively; 149,191 OCS-naïve patients were included. Frequency of GP, outpatient and A&E visits, hospitalisations, and admissions (including and excluding day cases) were higher in OCS versus OCS-naïve patients, and increased with more frequent patterns of intermittent OCS use (Table). Similar results were observed for average cost per patient for all visit types (total average cost £10,329.16 vs £5,215.87; Table).
Conclusion: In patients with asthma, intermittent OCS use was associated with increased HCRU and associated costs versus non-OCS use. More frequent patterns of OCS use were also associated with a higher burden on healthcare resources, suggesting that intermittent OCS use in the management of asthma should be limited when possible.
|Publication status||Accepted/In press - 7 Jun 2022|
|Event||EAACI HYBRID CONGRESS 2022 - Prague, Czech Republic|
Duration: 1 Jul 2022 → 3 Jul 2022
|Conference||EAACI HYBRID CONGRESS 2022|
|Period||1/07/22 → 3/07/22|