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The Association Between Short-Acting β2-Agonist Over-Prescription, and Patient-Reported Acquisition and Use on Asthma Control and Exacerbations: Data from Australia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年2月4日

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  • David Price,
  • Christine Jenkins,
  • Kerry Hancock,
  • Rebecca Vella,
  • Florian Heraud,
  • Porsche Le Cheng,
  • Ruth Murray,
  • Maarten Beekman,
  • Sinthia Bosnic-Anticevich,
  • Fabio Botini,
  • Victoria Carter,
  • Angelina Catanzariti,
  • Joe Doan,
  • Kirsty Fletton,
  • Ata Kichkin,
  • Thao Le,
  • Chantal Le Lievre,
  • Chi Ming Lau,
  • Dominique Novic,
  • John Pakos,
  • Kanchanamala Ranasinghe,
  • Alexander Roussos,
  • Josephine Samuel-King,
  • Anita Sharma,
  • Deb Stewart,
  • Bruce Willet,
  • Eric Bateman,
  • Rob Campbell,
  • Ying Liu,
  • Nicole O’Sullivan,
  • Ondrej Rejda,
  • Lisa Sugg,
  • Steph James,
  • Kiran Dhillon,
  • Sophie Jones

摘要

Introduction

In Australia, short-acting β2-agonists (SABA) are available both over the counter (OTC) and on prescription. This ease of access may impact SABA use in the Australian population. Our aim was to assess patterns and outcome associations of prescribed, acquired OTC and reported use of SABA by Australians with asthma.

Methods

This was a cross-sectional study, using data derived from primary care electronic medical records (EMRs) and patient completed questionnaires within Optimum Patient Care Research Database Australia (OPCRDA). A total of 720 individuals aged ≥ 12 years with an asthma diagnosis in their EMRs and receiving asthma therapy were included. The annual number of SABA inhalers authorised on prescription, acquired OTC and reported, and the association with self-reported exacerbations and asthma control were investigated.

Results

92.9% (n = 380/409) of individuals issued with SABA prescription were authorised ≥ 3 inhalers annually, although this differed from self-reported usage. Of individuals reporting SABA use (n = 546) in the last 12 months, 37.0% reported using ≥ 3 inhalers. These patients who reported SABA overuse experienced 2.52 (95% confidence interval [CI] 1.73–3.70) times more severe exacerbations and were 4.51 times (95% CI 3.13–6.55) more likely to have poor asthma control than those who reported using 1–2 SABA inhalers. Patients who did not receive SABA on prescription (43.2%; n = 311/720) also experienced 2.71 (95% CI 1.07–7.26) times more severe exacerbations than those prescribed 1–2 inhalers. Of these patients, 38.9% reported using OTC SABA and other prescription medications, 26.4% reported using SABA OTC as their only asthma medication, 13.2% were prescribed other therapies but not SABA OTC and 14.5% were not using any medication.

Conclusion

Both self-reported SABA overuse and zero SABA prescriptions were associated with poor asthma outcomes. The disconnect between prescribing authorisation, OTC availability and actual use, make it difficult for clinicians to quantify SABA use.