PMID- 24370344 OWN - NLM STAT- MEDLINE DCOM- 20140512 LR - 20141007 IS - 1097-6833 (Electronic) IS - 0022-3476 (Linking) VI - 164 IP - 4 DP - 2014 Apr TI - Demographic predictors of leukotriene antagonist monotherapy among children with persistent asthma. PG - 827-831.e1 LID - S0022-3476(13)01464-9 [pii] LID - 10.1016/j.jpeds.2013.11.029 [doi] AB - OBJECTIVE: To describe the children with persistent asthma receiving non-preferred controller therapy in the form of leukotriene receptor antagonist monotherapy (LTRAM). STUDY DESIGN: In this cross-sectional study, we analyzed 2007-2009 South Carolina Medicaid data of children aged 2- to 18 years with persistent asthma, defined by Healthcare Effectiveness Data and Information Set (HEDIS). Those without either LTRAM or inhaled corticosteroids (ICS) were excluded. With multivariable logistic regression modeling, we compared the outcome of LTRAM with the primary predictor of age and adjusted for covariates of race, sex, HEDIS class, rurality, and disease severity. We also used negative binomial regression to compare outcomes of albuterol and oral steroid claims, outpatient and emergency department visits, and hospitalizations with predictors of LTRAM vs ICS therapy. RESULTS: A total of 19,512 patients with asthma aged 2- to 18-years were studied: 2658 (13.6%) without controllers were excluded, 2508 (12.9%) received LTRAM, and 14 346 (73.5%) received ICS. Age, race, rurality, and HEDIS classification were all significantly associated with LTRAM (all P < .01): 5- to 13-year-olds relative to children <5 years old (OR 1.46, 95% CI 1.30-1.64), Caucasians relative to African Americans (OR 1.40, 95% CI 1.27-1.53), and rural children relative to urban (OR 1.18, 95% CI 1.08-1.3) were all more likely to receive LTRAM. Albuterol, oral steroid, and outpatient visits were lower in LTRAM (P < .01). No difference was detected in emergency department visits or admissions. CONCLUSIONS: Children 5- to 13-years of age, rural children, and Caucasian children were more likely to receive LTRAM. Uncovering provider rationale and practices as well as patient influences on this prescribing pattern may be helpful in optimizing asthma controller therapy. CI - Copyright (c) 2014 Mosby, Inc. All rights reserved. FAU - Wu, Chang L AU - Wu CL AD - Division of Hospital Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. Electronic address: cwu@peds.uab.edu. FAU - Andrews, Annie L AU - Andrews AL AD - Division of General Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, SC. FAU - Teufel, Ronald J 2nd AU - Teufel RJ 2nd AD - Division of General Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, SC. FAU - Basco, William T Jr AU - Basco WT Jr AD - Division of General Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, SC. LA - eng PT - Journal Article DEP - 20131225 PL - United States TA - J Pediatr JT - The Journal of pediatrics JID - 0375410 RN - 0 (Leukotriene Antagonists) SB - IM CIN - J Pediatr. 2014 Sep;165(3):642. PMID: 25152156 MH - Adolescent MH - Asthma/*drug therapy/*epidemiology MH - Child MH - Child, Preschool MH - Cross-Sectional Studies MH - Drug Utilization/statistics & numerical data MH - Female MH - Forecasting MH - Humans MH - Leukotriene Antagonists/*therapeutic use MH - Male EDAT- 2013/12/29 06:00 MHDA- 2014/05/13 06:00 CRDT- 2013/12/28 06:00 PHST- 2013/01/11 00:00 [received] PHST- 2013/09/20 00:00 [revised] PHST- 2013/11/13 00:00 [accepted] PHST- 2013/12/28 06:00 [entrez] PHST- 2013/12/29 06:00 [pubmed] PHST- 2014/05/13 06:00 [medline] AID - S0022-3476(13)01464-9 [pii] AID - 10.1016/j.jpeds.2013.11.029 [doi] PST - ppublish SO - J Pediatr. 2014 Apr;164(4):827-831.e1. doi: 10.1016/j.jpeds.2013.11.029. Epub 2013 Dec 25.