ArticlePediatrics2015
The pharmacy-level asthma medication ratio and population health.
Article in Pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Psychometric evaluation of the medication adherence report scale in caregivers of low-income, urban, African American children with poorly controlled asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2022Trial
- Participant-level characteristics differ by recruitment setting when evaluating a behavioral intervention targeting adolescents with asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2021Trial
- Identifying which children with persistent asthma have preventive medications available at home.The Journal of asthma : official journal of the Association for the Care of Asthma · 2020Trial
- Improving asthma self-management education through inhaler labeling.PEC innovation · 2024Article
- Impact of a pharmaceutical care incentive program on the asthma medication ratio among pediatric patients with persistent asthma enrolled in a Medicaid program.Journal of managed care & specialty pharmacy · 2021Article
- Design, methods, and baseline characteristics of a pilot, randomized, controlled trial of the effects of an electronic monitoring device on medication adherence in children with asthma.Contemporary clinical trials communications · 2021Article
- Neighborhood Risk and Hospital Use for Pediatric Asthma, Rhode Island, 2005-2014.Preventing chronic disease · 2019Article
- Poverty, Transportation Access, and Medication Nonadherence.Pediatrics · 2018Observational
- A missed primary care appointment correlates with a subsequent emergency department visit among children with asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2017Article
- Mapping Neighborhood Health Geomarkers To Clinical Care Decisions To Promote Equity In Child Health.Health affairs (Project Hope) · 2017Article
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND
objectivesCommunity pharmacies may be positioned for an increased role in population health. We sought to develop a population-level measure of asthma medication fills and assess its relationship to asthma-related utilization.
methodsWe conducted a retrospective, ecological study (2010-2012). Medication data from a chain of pharmacies (n = 27) within 1 county were used to calculate a Pharmacy-level Asthma Medication Ratio (Ph-AMR), defined as controller fills divided by controller plus rescue fills. Higher values are superior because they indicate more controller compared with rescue fills. The outcome was the asthma-related utilization rate among children in the same census tract as the pharmacy, calculated by dividing all emergency visits and hospitalizations by the number of children in that tract. Covariates, including ecological measures of poverty and access to care, were used in multivariable linear regression.
resultsOverall, 35 467 medications were filled. The median Ph-AMR was 0.53 (range 0.38-0.66). The median utilization rate across included census tracts was 22.4 visits per 1000 child-years (range 1.3-60.9). Tracts with Ph-AMR <0.5 had significantly higher utilization rates than those with Ph-AMR ≥0.5 (26.1 vs 9.9; P = .001). For every 0.1 increase in Ph-AMR, utilization rates decreased by 9.5 (P = .03), after adjustment for underlying poverty and access. Seasonal variation in fills was evident, but pharmacies in high-utilizing tracts filled more rescue than controller medications at nearly every point during the study period.
conclusionsPh-AMR was independently associated with ecological childhood asthma morbidity. Pharmacies may be a community-based leverage point for improving population-level asthma control through targeted interventions.
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