Abstract
Sex differences are well documented in chronic disease populations with cardiovascular disease and diabetes. Although recent research has suggested that asthma is more severe in older women compared to men, the extent of this difference remains poorly understood. The objective of this study was to compare rates of asthma-specific health services use (HSU) and medication use, between older women and men with asthma.
This population-based cohort study included 209 054 individuals aged ≥66 years with asthma from health administrative data in Ontario, Canada. The primary exposure was sex. Outcomes included asthma-specific HSU (spirometry, emergency department (ED), hospitalisation, physician office and specialist visits) and medication use (asthma controller and reliever prescriptions). Negative binomial regression models adjusted for age, socioeconomic status and comorbidities were used to ascertain outcomes by sex from 2010 to 2016.
Compared to men, women had lower rates of spirometry (adjusted relative rate (ARR) 0.87, 95% CI 0.85–0.89) and specialist visits for asthma (ARR 0.93, 95% CI 0.90–0.96), but higher rates of asthma-specific ED (ARR 1.43, 95% CI 1.33–1.53) and physician office visits (ARR 1.03, 95% CI 1.01–1.05). Women also had lower asthma controller (ARR 0.98, 95% CI 0.97–0.99) but higher asthma reliever (ARR 1.03, 95% CI 1.02–1.05) prescription fill rates, compared to men.
These findings may indicate poorer disease control, greater asthma severity and poorer access to specialist asthma care in women.
Abstract
Older women with asthma have lower rates of spirometry, asthma specialist visits and asthma controller fill rates, and higher rates of ED visits for asthma, physician office visits for asthma and asthma reliever fill rates, compared to men http://bit.ly/33PfMD6
Footnotes
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Conflict of interest: T. To has nothing to disclose.
Conflict of interest: N. Gray has nothing to disclose.
Conflict of interest: K. Ryckman has nothing to disclose.
Conflict of interest: J. Zhu has nothing to disclose.
Conflict of interest: I. Fong has nothing to disclose.
Conflict of interest: A. Gershon has nothing to disclose.
Support statement: This study was funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC), grant number HLTC3968IT-2018-501. Data were provided by ICES (formerly the Institute for Clinical Evaluative Sciences), which is funded by an annual grant from the MOHLTC. The analyses, conclusions, opinions and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received September 9, 2019.
- Accepted October 17, 2019.
- Copyright ©ERS 2019
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