Risk factors of asthma exacerbations in patients with intermittent asthma

We sought to identify risk factors (RF) associated with asthma exacerbation (AE) in intermittent asthma (IA) patients. we identified 202,155 adults 18-85 years old who, in 2013-2018, met criteria for IA: an asthma diagnosis on time t0 with no more than one asthma controller dispensing, two canisters of SABA dispensing and one AE (excluding hospitalization due to asthma) in the year prior to t0. We defined AE in the year following t0 as either a hospitalization or ED visit with a principal diagnosis of asthma or wheezing, or an outpatient visit for asthma with associated systemic or oral corticosteroids usage. We used robust Poisson regression models to identify RF associated with AE. 6.5% of patients developed AE (mean age 44 years, 64% female). After adjusting for other risk factors, older age, lower education, being female, non-white, overweight or obese, current smoker, Medi_Cal enrollee, having chronic sinusitis, nasal polyp, sleep disorders, anxiety, EOS≥150/mcL, Charlson comorbidity index score≥2, SABA or asthma controller dispensing, history of AE, asthma-related ED visit and asthma-related clinic visit were positively associated with AE, while having diabetes, hyperlipidemia, and being Medicare enrollee were negatively associated with AE (Figure 1). Hypertension, allergic or chronic rhinitis, dementia and heart disease were associated with AE in unadjusted analysis, but not in adjusted analysis. The assessment of AE risk factors for patients with IA is feasible and could be used as part of a risk management plan to facilitate high-quality care in patients with IA.