Prs56 Predictors of Psychological Distress and Its Influence on Reliever Medication Use in Asthma

Abstract

Objectives: Asthma affects more than 300 million people worldwide and over 26 million people in the US. Incidence of psychological distress (PD) in asthma, a consequence of coexisting psychological comorbidities like anxiety and/or depression, is on the rise. The study aims to identify sociodemographic and other factors that are associated with PD and assess its impact specifically on reliever medication use in Asthma. Methods: A retrospective, cross-sectional research data, obtained from the Medical Expenditure Panel Survey (MEPS, 2013(MEPS, -2015 and consisted of a sample of 5307 community dwelling asthmatics. PD was identified by using Kessler-6 scale (a score of $ 13), a self-administered written questionnaire embedded in MEPS. Use of three or more canisters of quick relief inhalers was defined as overuse of relievers. A Chi-square analyses was performed to test association between PD and reliever use. A set of logistic regression (LR) analyses was performed to determine the predictors of PD as well as reliever overuse in asthmatics with PD. Results: Compared to those without distress, a higher proportion of psychologically distressed asthmatics reported reliever overuse (2=310956.703, 23.3% vs 12.2%, p,0.0001). Female asthmatics were 32.3% more likely to have PD than males (OR=1.323, C.I=1.320-1.326, p,0.0001). The LR results revealed that female asthmatics within the PD group were more likely to overuse relievers than males (OR= 2.263, C.I= 2.255-2.2343, p,0.0001), and those with 12 years or more of education were less likely to overuse relievers compared to those with less education (OR=0.555, C.I=0.553-0.556, p,0.0001). A Phi correlation coefficient (r4=-0.103) revealed a significant negative correlation between PD scores and reliever overuse. Conclusions: Comorbidity of PD in asthma is associated with over-utilization of reliever medications. Inappropriate medication use can affect treatment plan, compromise patient's quality of life, and increase the overall cost of care in asthma.