OBJECTIVES

: We aimed to evaluate whether the use of ICS increase the risk of pneumonia in asthmatic patients using the Health Insurance Review and Assessment Service (HIRA) database in Korea.

METHODS

: The data of Asthma Management Adequacy Assessment performed by the HIRA in Korea was analyzed. Patients who were prescribed asthma medications more than 2 times with claimed insurance benefits of asthma disease codes were enrolled. In the data, demographics of patients, asthma medications, healthcare use, and complications were analyzed.

RESULTS

Patients using ICS were older and had more comorbidities than the patients not using ICS. They visited more frequently outpatient and emergency room and hospitalized more frequently. They also had more pneumonia and other complications and used more respiratory medications. In the multivariate analysis, age, female, medical care patients, patients of secondary and tertiary hospitals, Charlson comorbidity index, and patients had hospitalized for asthma in the past year were risk factors for pneumonia occurrence. After adjusting confounding factors mentioned above, ICS prescription was an independent risk factor for pneumonia.

CONCLUSIONS

: ICS use was associated with increasing pneumonia in asthmatic patients in the national health insurance data of Korea. Although further research through prospective study design is warranted, the possibility that the use of ICS can increase the risk of pneumonia in asthmatics should be considered and careful attention should be paid to the prevention of pneumonia.