Impact of the COVID-19 pandemic on adult asthma-related health care utilization – Research

Background:

The coronavirus 2019 disease (COVID-19) pandemic prompted major disruptions in chronic disease self-management and health care delivery, yet its impact on adults with asthma remains poorly characterized.

Objective:

Our aim was to assess changes in asthma-related health care utilization among adults during the COVID-19 pandemic (2020) compared with before the pandemic (2017-2019) and after the pandemic (2021-2024) within a large, multihospital health system.

Methods:

We conducted a retrospective electronic health record-based study of 42,242 adults with asthma who were receiving care at Penn Medicine from 2017 to 2024. Weekly counts of 5 encounter types (refill, telemedicine, telephone/audio, outpatient, and emergency encounters) and prescriptions for short-acting β-agonists, inhaled corticosteroids, and oral corticosteroids were compared across years. Generalized linear models evaluated changes in encounter rates during the pandemic and postpandemic periods relative to prepandemic levels, stratified by key transition intervals in 2020.

Results:

From 2017 to 2019, adults averaged 397 weekly asthma-related visits; in 2020, this number increased to 481. During the lockdown weeks, refill and telemedicine encounters rose by 123% and 36,445%, respectively, whereas outpatient visits declined by 65%. Prescriptions for short-acting β-agonists and inhaled corticosteroids increased by 73% and 43%, respectively, whereas oral corticosteroid prescriptions decreased by 5%. Primary care visits spiked during the lockdown, whereas allergy/immunology and pulmonary encounters remained stable throughout the year.

Conclusion:

The COVID-19 pandemic was associated with major shifts in adult asthma care, characterized by short-term surges in primary care visits and medication refills and reductions in in-person encounters. These patterns illustrate the capacity of asthma care systems to rapidly adapt, and they highlight the need to tailor future crisis response strategies to adult patients.