Trends in Medication Use among Adults with Asthma

In the years between 1998 and 2009, the number of adults reporting treatment for asthma nearly doubled from 5.5 million (2.7% of US adults ≥18 years of age) in 1998 to 10.3 million (4.5%). Asthma is a chronic respiratory disease that causes the lungs to become inflamed and constricted.

Management of asthma requires appropriate medications. Current treatment guidelines recommend the use of relievers as needed to control intermittent asthma, and the use of relievers in combination with controllers to treat persistent asthma. Oral corticosteroids are used for severe exacerbation, or to treat the most severe asthma symptoms that do not respond to other medications.

The Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS) recently released Statistical Brief #378 outlining changes in the percentage of adults reporting treatment for asthma in 1998 to 1999 and 2008 to 2009 by selected demographic and socioeconomic characteristics. The brief is titled Asthma Medication Use among Adults with Reported Treatment for Asthma, United States, 1998-1999 and 2008-2009.

The estimates in the brief were derived from the Household Component of the MEPS and augmented by the Medical Provider Component. All differences are statistically significant at the .05 level or better.

The MEPS report analyzed patients with asthma by age, race/ethnicity, sex, education, family income, and insurance status. The characteristics were divided into subgroups: age, 18, 18 to 44, 45 to 64, and ≥65 years; race/ethnicity, white non-Hispanic, black non-Hispanic, and Hispanic; sex, male and female; education, <12 years, 12 years, and >12 years; family income, poor/near poor, low, middle, and high; and insurance status, any private, public only, uninsured, and for those ≥65 years of age, Medicare only, Medicare + private, and Medicare + public.

Comparison of data from 1998 to 1999 and 2008 to 2009 revealed that in all subgroups, with the exception of uninsured nonelderly adults, the treated prevalence of asthma increased. For 2008 to 2009, analyses within groups show that adults ≥65 years of age were more likely to report treatment for asthma than those 18 to 44 and 45 to 64 years of age; non-Hispanic whites and non-Hispanic blacks were more likely than Hispanics; females were more likely than males; those with <12 years of education were more likely than those with ≥12 years of education; those in families with poor/near poor or low income were more likely than those in families at the high-income level; among adults <65 years of age, those with public-only insurance were more likely than those with private insurance (uninsured adults were less likely than those with private insurance); and among adults ≥65 years of age, those with Medicare and other public insurance were more likely than those with Medicare only.

Compared with 1998 to1999, adults in 2008 to 2009, who reported treatment for asthma, were more likely to use controller medications and less likely to use relievers. Subgroup analyses revealed that the use of controllers increased between 1998 to 1999 and 2008 to 2009 for females, adults in families at the high-income level, and adults <65 years of age who had private insurance.

Data for 2008 to 2009 show that adults ≥45 years of age, white non-Hispanics, those with >12 years of education, those in families with high income, and those 18 to 64 years of age who had private insurance were more likely to use controllers. Those more likely to use relievers without the addition of controllers in 2008 to 2009 were adults 18 to 44 years of age, Hispanics, males, those with <12 years of education, those in poor/near poor and low-income families, and those 18 to 64 years of age with public-only insurance or who were uninsured.