9 Proactive identification of patients with undertreated asthma

Goals: Asthma is a common condition affecting over 25 million Americans. Despite high prevalence, asthma is often undertreated, resulting in significant preventable morbidity and mortality. Our goal was to identify and characterize individuals with undertreated asthma to inform tailored interventions designed to improve care access and outcomes. Methods/Study Population: We used electronic health records (EHR) to identify patients with suspected undertreated asthma receiving care in a large, multi-site state-wide healthcare system serving >2 million people. Undertreated asthma was defined by 1) history of emergency department visit or hospitalization for asthma exacerbation or asthma-related symptoms and 2) no prior history of treatment with inhaled corticosteroids, the standard of care preventative treatment for patients with asthma. Asthma symptoms were defined as wheezing, cough, and dyspnea. Patients were required to have been treated with systemic corticosteroids and inhaled beta agonists (standard treatment for asthma exacerbation) and have history of eosinophilia to increase the specificity of asthma diagnosis. Results/Anticipated Results: We identified 3,318 people with suspected undertreated asthma evaluated between 2019 and 2024. These patients had high rates of healthcare utilization with a mean of 7.3 any-cause emergency department visits and 1.4 hospitalizations over the 5-year study period. Black and Hispanic patients were less likely to have a documented primary care physician or prior pulmonologist referral order when compared to white and non-Hispanic patients, respectively. Insurance coverage rates did not differ significantly between these racial/ethnic groups. Discussion/Significance of Impact: Individuals identified as having suspected undertreated asthma were found to have high healthcare utilization. Significant racial and ethnic disparities were observed, with associated gaps in primary and specialty care not explained by insurance status, highlighting potential opportunities for improving care and addressing disparities.