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Am. J. Respir. Crit. Care Med., Volume 165, Number 2, January 2002, 190-194

Assessment of a Medication-Based Asthma Index for Population Research

WENDY J. UNGAR, KENNETH R. CHAPMAN, and MARIA T. SANTOS

Division of Population Health Sciences, Hospital for Sick Children Research Institute; Department of Health Policy, Management and Evaluation, and Division of Respiratory Medicine, Faculty of Medicine, University of Toronto; and The Asthma Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

Asthma management guidelines recommend the use of preventive medications in sufficient amounts to control asthma symptoms. The validity of a medication use index as a proxy for asthma severity has not been established. We recruited 1,279 Ontario adults with asthma or parents of children with asthma from a community-based surveillance program in 1995-96. Participants completed a telephone questionnaire at baseline, 3 and 6 mo. The questionnaire gathered information about asthma medication use, health care utilization, and symptoms. Asthma was classified as mild in 28%, moderate in 49%, or severe in 23% of patients based on the amount and types of medication used. There were significant differences among groups in health resource use such that adults with higher medication use visited primary care physicians and specialists more frequently, had pulmonary functions tests more frequently, and were admitted to hospital more frequently. The findings among children were similar. There were weak positive correlations between medication use and symptom frequency in adults and children. We conclude that a medication use index may be useful in population-based research where clinical asthma severity data are lacking. Such an index is distinct from but is related to disease control.




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