BACKGROUND: The COVID-19 pandemic increased reliance
on virtual care for patients with persistent asthma.
OBJECTIVE: This retrospective cohort study assessed changes
from in-person to virtual care during the pandemic. In patients
with persistent asthma, compared with the same period before
the pandemic.
METHODS: Kaiser Permanente Colorado members aged 18 to
99 years with persistent asthma were evaluated during two
periods (March to October 2019 and March to October 2020).
Comparison of asthma exacerbations (hospitalizations,
emergency department visits, and courses of oral prednisone)
and asthma medication metrics were evaluated between the two
periods and by type of care received during the pandemic (no
care, virtual care only, in-person care only, or a mix of virtual
and in-person care). Population characteristics by type of care
received during the pandemic were also evaluated.
RESULTS: Among 7,805 adults with persistent asthma, those
who used more virtual care or sought no care during the
pandemic were younger and had fewer comorbidities, mental
health diagnoses, or financial barriers. Exacerbations decreased
(0.264 to 0.214; P <.001) as did courses of prednisone (0.213 to
0.169). Asthma medication adherence (0.53 to 0.54; P <.001)
and the asthma medication ratio, a quality-of-care metric (0.755
to 0.762; P [ .019), increased slightly. Patients receiving a mix
of in-person and virtual care had the highest rate of exacerbations (0.83) and a lower asthma medication ratio (0.74) despite
having the highest adherence (.57).
CONCLUSIONS: Despite an increase in virtual care, asthma
exacerbations decreased except among individuals who received
both in-person and virtual care, likely because they had more severe disease.Ye
