1. German regional variation of acute and high oral corticosteroid use for asthma
- Author
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Eugene R. Bleecker, Cassandra Nan, Yasemin Ilgin, Thomas Schultz, Robert Lindner, Olaf Schmidt, and Lykke Hinsch Gylvin
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.drug_class ,Administration, Oral ,Asthma treatment ,Disease ,Physician education ,Health informatics ,German ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,immune system diseases ,Internal medicine ,Germany ,Health insurance ,Humans ,Immunology and Allergy ,Medicine ,Anti-Asthmatic Agents ,030212 general & internal medicine ,Medical prescription ,Intensive care medicine ,Asthma ,business.industry ,Medical record ,medicine.disease ,Obstructive lung disease ,language.human_language ,respiratory tract diseases ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,language ,Corticosteroid ,Corticosteroid use ,business - Abstract
To improve understanding of real-world asthma treatment and inform physician education, we evaluated regional variation in asthma prevalence and oral corticosteroid (OCS) use across Germany. We developed a machine learning gradient boosted tree model with IMS® Disease Analyzer electronic medical records, which cover 3% of German patients. This model had a 91% accuracy in predicting the presence of asthma and chronic obstructive pulmonary disease. We applied the model to the IMS® Longitudinal Prescription database, with 82% national coverage, to classify patients receiving treatment for airflow obstruction from October 2017–September 2018 in 63 regions in Germany. Of 2.4 million individuals under statutory health insurance with predicted high OCS use for asthma (defined as 1 tablet per day for the duration of therapy), 13.7%, 18.7%, 36.5%, 29.4%, and 1.7% were categorised as receiving Global Initiative for Asthma (GINA) Steps 1, 2, 3, 4, and 5 treatment, respectively. Approximately 7–15% of those receiving GINA Steps 1–4 treatment, and 35% of those receiving Step 5 treatment received ≥1 acute OCS prescription (duration
- Published
- 2021