--- title: "Oral corticosteroid use in pts with asthma using EHRs. | Sutter Health" description: "Oral corticosteroid prescriptions for asthma patients are frequently ordered for conditions unrelated to asthma." url: "https://www.sutterhealth.org/research/publications/oral-corticosteroid-use-in-pts-with-asthma-using-ehrs-1055312604" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Oral corticosteroid use in pts with asthma using EHRs. # Electronic health record-based assessment of oral corticosteroid use in a population of primary care patients with asthma: an observational study. Allen-Ramey FC, Nelsen LM, Leader JB, Mercer D, Kirchner HL, & Jones JB. _Allergy Asthma Clin Immunol. 9(1):27. doi: 10.1186/1710-1492-9-27._ 2013-08-07 ## Abstract BACKGROUND: Oral corticosteroid prescriptions are often used in clinical studies as an indicator of asthma exacerbations. However, there is rarely the ability to link a prescription to its associated diagnosis. The objective of this study was to characterize patterns of oral corticosteroid prescription orders for asthma patients using an electronic health record database, which links each prescription order to the diagnosis assigned at the time the order was placed. METHODS: This was a retrospective cohort study of the electronic health records of asthma patients enrolled in the Geisinger Health System from January 1, 2001 to August 23, 2010. Eligible patients were 12-85 years old, had a primary care physician in the Geisinger Health System, and had asthma. Each oral corticosteroid order was classified as being prescribed for an asthma-related or non-asthma-related condition based on the associated diagnosis. Asthma-related oral corticosteroid use was classified as either chronic or acute. In patient-level analyses, we determined the number of asthma patients with asthma-related and non-asthma-related prescription orders and the number of patients with acute versus chronic use. Prescription-level analyses ascertained the percentages of oral corticosteroid prescription orders that were for asthma-related and non-asthma-related conditions. RESULTS: Among the 21,199 asthma patients identified in the electronic health record database, 15,017 (70.8%) had an oral corticosteroid prescription order. Many patients (N = 6,827; 45.5%) had prescription orders for both asthma-related and non-asthma-related conditions, but some had prescription orders exclusively for asthma-related (N = 3,450; 23.0%) or non-asthma-related conditions (N = 4,740; 31.6%). Among the patients receiving a prescription order, most (87.5%) could be classified as acute users. A total of 60,355 oral corticosteroid prescription orders were placed for the asthma patients in this study-31,397 (52.0%) for non-asthma-related conditions, 24,487 (40.6%) for asthma-related conditions, and 4,471 (7.4%) for both asthma-related and non-asthma-related conditions. CONCLUSIONS: Oral corticosteroid prescriptions for asthma patients are frequently ordered for conditions unrelated to asthma. A prescription for oral corticosteroids may be an unreliable marker of asthma exacerbations in retrospective studies utilizing administrative claims data. Investigators should consider co-morbid conditions for which oral corticosteroid use may also be indicated and/or different criteria for assessing oral corticosteroid use for asthma. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/23924393) ![J.B. Jones, Ph.D., MBA](https://dyn.mktgcdn.com/p/rIQfkoa5XfKJYCHSVrDKsACQSNJ7jTljZTHKC4Lae2E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) J.B. Jones, Ph.D., MBA Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jb-jones-phd-mba-1049680984) ## Research topics - [Asthma](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Asthma%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Lower copay and oral administration: predictors of first-fill adherence to new asthma prescriptions.](https://www.sutterhealth.org/research/publications/predictors-of-first-fill-of-new-asthma-prescriptions-1055312786) Berger Z, Kimbrough W, Gillespie C, Boscarino JA, Wood GC, Qian Z, Jones JB, Shah NR. Am Health Drug Benefits. 2(4):174-80. 2009 Jun 01 - Publication ### [Adult obesity and office-based quality of care in the United States.](https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917) Ma J, Xiao L, Stafford RS. Obesity. 17(5):1077–1085. 2009 May 01 - Publication ### [Using the PARAFAC2 tensor factorization on EHR audit data to understand PCP desktop work.](https://www.sutterhealth.org/research/publications/parafac2-tensor-factorization-on-ehr-audit-data-pcp-work-1055312822) Perros I, Yan X, Jones JB, Sun J, Stewart WF. J Biomed Inform. 101:103312. doi: 10.1016/j.jbi.2019.103312. Epub 2019 Oct 15. 2020 Jan 01 - Publication ### [Mediators of asthma outcomes](https://www.sutterhealth.org/research/publications/mediators-of-asthma-outcomes-1055312653) Rand CS, Wright RJ, Cabana MD, Foggs MB, Halterman JS, Olson L, Vollmer WM, Wilson SR, Taggart V. J Allergy Clin Immunol. 129(3 Suppl):S136-41. 2012 Mar 01 - Publication ### [Secondhand tobacco smoke in children with asthma: sources of and parental perceptions about exposure in children and parental readiness to change.](https://www.sutterhealth.org/research/publications/parents-smoking-and-children-with-asthma-1055312631) Farber HJ, Knowles SB, Brown NL, Caine L, Luna V, Qian Y, Lavori P, Wilson SR. Chest. 133(6):1367-74. doi: 10.1378/chest.07-2369. Epub 2008 Mar 13. 2008 Jun 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/oral-corticosteroid-use-in-pts-with-asthma-using-ehrs-1055312604#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Oral corticosteroid use in pts with asthma using EHRs."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/oral-corticosteroid-use-in-pts-with-asthma-using-ehrs-1055312604#medicalscholarlyarticle","name":"Electronic health record-based assessment of oral corticosteroid use in a population of primary care patients with asthma: an observational study.","headline":"Oral corticosteroid use in pts with asthma using EHRs.","abstract":"BACKGROUND: Oral corticosteroid prescriptions are often used in clinical studies as an indicator of asthma exacerbations. However, there is rarely the ability to link a prescription to its associated diagnosis. The objective of this study was to characterize patterns of oral corticosteroid prescription orders for asthma patients using an electronic health record database, which links each prescription order to the diagnosis assigned at the time the order was placed. METHODS: This was a retrospective cohort study of the electronic health records of asthma patients enrolled in the Geisinger Health System from January 1, 2001 to August 23, 2010. Eligible patients were 12-85 years old, had a primary care physician in the Geisinger Health System, and had asthma. Each oral corticosteroid order was classified as being prescribed for an asthma-related or non-asthma-related condition based on the associated diagnosis. Asthma-related oral corticosteroid use was classified as either chronic or acute. In patient-level analyses, we determined the number of asthma patients with asthma-related and non-asthma-related prescription orders and the number of patients with acute versus chronic use. Prescription-level analyses ascertained the percentages of oral corticosteroid prescription orders that were for asthma-related and non-asthma-related conditions. RESULTS: Among the 21,199 asthma patients identified in the electronic health record database, 15,017 (70.8%) had an oral corticosteroid prescription order. Many patients (N = 6,827; 45.5%) had prescription orders for both asthma-related and non-asthma-related conditions, but some had prescription orders exclusively for asthma-related (N = 3,450; 23.0%) or non-asthma-related conditions (N = 4,740; 31.6%). Among the patients receiving a prescription order, most (87.5%) could be classified as acute users. A total of 60,355 oral corticosteroid prescription orders were placed for the asthma patients in this study-31,397 (52.0%) for non-asthma-related conditions, 24,487 (40.6%) for asthma-related conditions, and 4,471 (7.4%) for both asthma-related and non-asthma-related conditions. CONCLUSIONS: Oral corticosteroid prescriptions for asthma patients are frequently ordered for conditions unrelated to asthma. A prescription for oral corticosteroids may be an unreliable marker of asthma exacerbations in retrospective studies utilizing administrative claims data. 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