Document Type
Presentation
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Publication Date
6-28-2024
Abstract
Differences in asthma prevalence and outcomes have been demonstrated based on racialized groups in the United States. In general, the use of biologic medications in asthma has led to improved care with decreased rates of exacerbations and the need for oral corticosteroids. However, the utilization of these medications in groups with historically disproportionate outcomes in asthma is not well known. This two-part, retrospective study of a single, large healthcare system assessed the presence of a difference in the effect of biologic medications across racialized groups and the rates of utilization amongst eligible patients in 2022. Part 1 included patients who met the criteria for difficult-to-treat asthma based on the Global Initiative for Asthma (GINA) guidelines and had at least one exacerbation or were prescribed a biologic during the first half of 2022. In a linear regression model, differences in exacerbation rate in the second half of 2022 across racialized groups were assessed using a race-by-treatment interaction. Part 2 included patients who met the GINA guidelines for difficult-to-treat asthma and were either prescribed a biologic or were not but had an absolute eosinophil count greater than 150 cells per microliter. Logistic regression was used to determine differences in biologic utilization between racialized groups. There was no evidence of a difference in the effect of biologic medications based on racialized groups. There was, however, evidence to suggest lower odds of biologic prescriptions in eligible patients identifying as Hispanic compared to those identifying as White (OR 0.54, 95% CI 0.69-1.02, p-value
Lay Summary
Prior studies have shown that people who identify as Black, Puerto Rican, Native American, or Alaska Native are more likely to have asthma than other racial groups. They also are more likely to have more severe asthma. This means they are at a higher risk for serious health problems from their asthma. Newer medications can lower this risk of serious health problems. It is unknown whether these medications are reaching everyone equally, however. This study tried to see if different groups were being given these medications at the same rate. Patients were included if they were seen at least once for asthma in 2022 and had ongoing symptoms despite treatment. The study showed that people who identified as Hispanic had the same benefit from newer medications as people who identified as White but were given them less often. The COVID-19 pandemic and the limitations of the information available from the electronic medical record may have impacted the results of this study. Differences in the use of these newer medications may cause certain groups to do worse with their asthma than others. Future studies and public health programs are needed to understand and limit these differences.
Recommended Citation
Mallozzi, MD, Mark, "Asthma Disparities in the Age of Biologics" (2024). Master of Public Health Capstone Presentations. Presentation 553.
https://jdc.jefferson.edu/mphcapstone_presentation/553
Language
English
Comments
Presentation: 6:00
Poster attached as supplemental file below