Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics

Abstract

Elderly patients with asthma have relatively high rates of hospitalization and mortality. Although inhaled corticosteroids have been shown to improve outcomes among younger patients with asthma, their usefulness in elderly patients has not been established. Therefore, a population-based study of patients 65 yrs of age or older, who have been hospitalized at least once with asthma in Ontario, Canada was conducted to determine the impact of inhaled corticosteroids on rehospitalization for asthma and all-cause mortality rates. Data from the Canadian Institute of Health Information was used to capture all patients 65 yrs of age and older who were hospitalized at least once, with the most responsible diagnosis of asthma in Ontario, Canada between fiscal year 1992 and 1996. This database was then linked with drug claims, physician billing and mortality databases. In total, 6,254 consecutive elderly patients with asthma were identified. Sixty percent of these patients were given at least one prescription for inhaled corticosteroids within 90 days postdischarge from their index hospitalization for asthma. Users of inhaled corticosteroids postdischarge were 29% (95% confidence interval (CI) 20%-38%) less likely to be readmitted to hospital for asthma and 39% (95% CI, 20%-53%) less likely to experience all-cause mortality compared to those who did not receive these drugs postdischarge over a one year follow-up period. These findings suggest that inhaled corticosteroids are beneficial in reducing the risk for rehospitalization and all-cause mortality in elderly patients with asthma who have recently been hospitalized for their disease.