PAS2 DRUG ADVERSE EVENTS MODIFYTHE TREATMENT AND COMPLIANCE OF ASTHMA PATIENTS

PAS1 LEAVING AGAINST MEDICAL ADVICE (LAMA) IN ASTHMA EXACERBATION: CHARACTERISTICS AND DETERMINANTS OF LEAVERS Tano BD Johns Hopkins University School of Medicine, Baltimore, MD, USA OBJECTIVE: Leaving against medical advice is a frustrating event for physicians and medical staff and a costly behavior for the patients. Studies have shown that in asthma exacerbation, this decision by patients can lead to death. This study purports to assess the determinants and characteristics of LAMA asthmatic patients. METHODS: Healthcare Cost and Utilization Project (HCUP) data are used. The study focuses on years 1997–2003 and only 2003 results are reported. Four International Classification of Diseases, 9th Revision for asthma are considered: Chronic obstructive asthma with acute exacerbation (493.22), asthma without status asthmaticus (493.90), asthma with status asthmaticus (493.91) and asthma with acute exacerbation (493.92). Results are reported based on these ICD-9 codes respectively. RESULTS: Though the overall national LAMA rate is less than one percent (0.84), it is found that LAMA is more prevalent in asthmatic patients who are uninsured (2.9, 4.1, 4.1, and 5.0%) compared with Medicare and Commercial insurance LAMA rates that are both less than 1% in this database. LAMA patients tend to have low income ($0–25,000) (1.7, 1.4, 1.5, and 2.7%) compared to not low income ($25,000+) (1.2, 1.0, 1.2, and 1.6%), and are Medicaid recipients (2.9, 1.3, 1.3 and 2.7%). The demographic characteristics of LAMA patients showed that prime age asthmatics (ages 18–44) have the highest rates (3.3, 3.4, 4.5, and 4.8%), followed by middle age adults (ages 45–64) (1.8, 1.5, 2.1, and 2.1%). The very young (ages < 1 and 1–17) and the older adults (ages 65+) have minimal LAMA rates. Males have slightly more LAMA rates than females (2.2, 1.1, 1.2, 2.5%) vs. (1.0, 1.1, 1.4, 1.8%) respectively. CONCLUSION: Leaving AMA, a surrogate marker for non-adherence/noncompliance in hospitalized patients coincides with poverty. Therefore, educational measures used to remediate these behaviors can be used to help these patients.