AMR: Asthma Medication Ratio

Asthma Medication Ratio (AMR) is a HEDIS measure that focuses on patients with persistent asthma and looks at the number of their controller medication fills in relation to total asthma medication fills (rescue and controller). 

Did you know?

• In 2022, current asthma rates in Ohio were 163,800 (6.8%) in children and 1,042,400 (11.4 %) in adults. ¹
• Up to 80% of patients cannot use their inhaler correctly!
• At least 50% of adults and children do NOT take controller medications as prescribed.
• Regular use of SABA (short acting beta agonist), even for 1-2 weeks, is associated with increased AHR (airway hyperresponsiveness), reduced bronchodilator effect, increased allergic response, and increased eosinophils. This can lead to a vicious cycle encouraging overuse. Overuse of SABA is associated with increased exacerbations and increased mortality. ²

Current Buckeye Health Plan Initiatives:

1. In conjunction with our data analytics team, a daily report is generated that identifies BHP members who are non-adherent to their asthma controller medications.
2. Our pharmacy team makes a fax attempt to each provider for each member identified, noting the last fill date and day supply of the asthma controller medication.
3. Our pharmacy team also sends out text messages to members who are non-adherent to their asthma controller medications, reminding them that their medication is important in controlling their asthma.  
4. In addition, our pharmacy team also sends out educational text messages to our asthma members regarding topics such as asthma triggers, smoking cessation, children having inhalers at school, and vaccinations.   

Please consider the following:

1. During each visit with the member, review their medication list and ask if there are any issues with filling or taking medications as prescribed.
2. Provide an asthma action plan if the member does not already have one.  
3. Discuss with members the difference between their rescue inhalers and controller inhalers/medications and make sure they understand how and when to use each.  
4. Consider prescribing a spacer with a mask to ensure the member is using their inhaler correctly and getting the full dose.
5. Address medication therapy if a member is overutilizing their rescue inhaler.
6. Determine if SMART (Single Maintenance and Reliever Therapy) may be appropriate for a member.
7. Offer a 90 day supply of medications to help improve adherence and lessen member trips to the pharmacy.
8. Continue to monitor a member’s progress and follow up as needed.

See our latest SMART article for therapy options. 

For more information and improvement tips see the AMR page of our HEDIS Reference Guide (PDF).

References:

1. American Lung Association. (2024). Asthma Trends and Burden. 
2. Global Initiative For Asthma (GINA). (2024).