OBJECTIVES : More than 26 million people suffer from asthma in the United States and incidence of mental health comorbidities is on the rise among individuals with asthma. Past evidence, although inconclusive, suggests that symptoms of Psychological Distress (PD), characterized by anxiety and/or depression, may affect the daily use of controller medications in asthmatics and impact substantially the utilization of medical resources as well. The aim of our study was to: 1) to compare the daily use of controller medications between asthmatics with and without PD, and 2) to assess the effect of PD-related comorbidity on the utilization of medical care resources (hospital outpatient, ER and office-based visits).

METHODS: Retrospective, cross-sectional data, obtained from the Medical Expenditure Panel Survey (MEPS, 2013-2015), was utilized to obtain a sample of 5307 community-dwelling asthmatic adults. Individuals with symptoms of PD were identified using Kessler-6 scale (a score of ≥ 13). Student’s t test was used to compare medical resource utilization between two groups (PD vs no PD). Chi-square analysis was conducted to determine the association between PD and daily use of controller medications.

RESULTS: Utilization of controllers on a daily basis was greater in asthmatics with PD as compared to those without PD (chi-square=23109.37, 62.5% vs 57.4%, p<0.0001). As for medical resource utilization, asthmatics with PD had a greater number of mean outpatient department provider visits (1.7 vs 1.01, p<0.0001) and ER visits (0.95 vs 0.37, p<0.0001) as compared to those without PD. Controller use was also greater in individuals with higher income, >12 years of education, nonsmokers and those having private insurance.

CONCLUSIONS: Comorbidity of PD leads to increased medical resource utilization and daily use of controllers. A timely assessment of PD at the point of care is necessary to understand its impact on medication adherence and for optimizing health outcomes in asthma patients.