TY - JOUR
T1 - The association between short-acting β2-agonist over-prescription, and patient-reported acquisition and use on asthma control and exacerbations
T2 - data from Australia
AU - Price, David
AU - Jenkins, Christine
AU - Hancock, Kerry
AU - Vella, Rebecca
AU - Heraud, Florian
AU - Le Cheng, Porsche
AU - Murray, Ruth
AU - Beekman, Maarten
AU - Bosnic-Anticevich, Sinthia
AU - Botini, Fabio
AU - Carter, Victoria
AU - Catanzariti, Angelina
AU - Doan, Joe
AU - Fletton, Kirsty
AU - Kichkin, Ata
AU - Le, Thao
AU - Le Lievre, Chantal
AU - Lau, Chi Ming
AU - Novic, Dominique
AU - Pakos, John
AU - Ranasinghe, Kanchanamala
AU - Roussos, Alexander
AU - Samuel-King, Josephine
AU - Sharma, Anita
AU - Stewart, Deb
AU - Willet, Bruce
AU - Bateman, Eric
N1 - Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2024/3
Y1 - 2024/3
N2 - 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.
AB - 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.
KW - Asthma management
KW - Asthma outcomes
KW - Over-the-counter medication
KW - Prescription patterns
KW - Short-acting β2-agonists
UR - http://www.scopus.com/inward/record.url?scp=85184717738&partnerID=8YFLogxK
U2 - 10.1007/s12325-023-02746-0
DO - 10.1007/s12325-023-02746-0
M3 - Article
C2 - 38310584
AN - SCOPUS:85184717738
SN - 0741-238X
VL - 41
SP - 1262
EP - 1283
JO - Advances in Therapy
JF - Advances in Therapy
IS - 3
ER -