Individuals in the denominator who fulfilled at least one the following criteria:
1. The patient was dispensed at least eight prescriptions of asthma medications during the measurement year and the year prior to the measurement year; if and only if at least four prescriptions were dispensed during the measurement year.
2. The patient was dispensed at least two prescriptions of asthma medication and also had at least four outpatient visits with an asthma diagnosis in each of the two years (the measurement year and the one prior to It).
3. The patient was dispensed at least four prescriptions of asthma medications during one of the reference years (the measurement year and the one prior to it); and was dispensed at least two asthma medications and had at least four outpatient visits with an asthma diagnosis in the other.
Note: Medications – if a chronic prescription is used, the number of months of usage should be counted for defining the numerator.
Individuals aged 5-44
Asthma is one of the most common chronic diseases in the world. Although asthma-related complications have decreased in developed countries over the past decade, the disease still significantly affects quality of life and places a considerable economic burden (1)(2). A distinction is made between persistent asthma and intermittent asthma; persistent asthma is characterized by a high frequency of symptoms that require preventive drug treatment. Asthma treatment is divided into two categories: preventive treatment aimed at achieving long-term disease control, and relief treatment used during acute attacks. The cornerstone of treatment for persistent asthma is the regular use of preventive medications, primarily inhaled corticosteroids. Preventive treatment has been proven effective in improving symptoms and reducing the risk of exacerbations, hospitalizations, and mortality (3)(4). Overuse of reliever medications (primarily inhaled short acting beta-agonists) indicates inadequate control and is associated with adverse outcomes.
In addition, asthma patients are at increased risk of complications from inflammatory respiratory diseases, which can worsen to the point of requiring hospitalization. Influenza vaccination significantly reduces emergency room visits and hospitalizations; therefore, the Ministry of Health recommends that all asthma patients aged six months and older receive an annual flu vaccine (5)(6).
World Health Organization. Asthma [Internet]. 2017 [cited 2023 Feb 8]. Available from:1 https://www.who.int/news-room/fact-sheets/detail/asthma
2. Soriano JB, Abajobir AA, Abate KH, Abera SF, Agrawal A, Ahmed MB, et al. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017 Sep 1;5(9):691–706.
3. Practice C. Guidelines Asthma Source Guideline National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program, Expert Panel [Internet]. 2018. Available from: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf
4. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention [Internet]. 2015. Available from: www.ginasthma.org.
5. Ministry of Health | Public Health Services | Department of Epidemiology. Vaccination Guidelines – August 2019 Update. 2019.
6. Ministry of Health. Prevention of Seasonal Influenza and Other Winter Diseases [Internet]. [cited 2023 Feb 8]. Available from: https://www.gov.il/he/Departments/Guides/disease-flu?chapterIndex=2
