Predictors of inappropriate and excessive use of reliever medications in asthma: a 16-year population-based study

Hamid Tavakoli, J. Mark FitzGeraldLarry D. Lynd and Mohsen Sadatsafavi

Abstract

Background

Understanding factors associated with the inappropriate or excessive use of short-acting beta agonists (SABA) can help develop better policies.

Methods

We used British Columbian (BC)‘s administrative health data (1997–2014) to create a retrospective cohort of asthma patients aged between 14 and 55 years. The primary and secondary outcomes were, respectively, inappropriate and excessive use of SABA based on a previously validated definition. Exposures were categorised into groups comprising socio-demographic variables, indicators of type and quality of asthma care, and burden of comorbid conditions.

Results

343,520 individuals (56.3% female, average age 30.5) satisfied the asthma case definition, contributing 2.6 million person-years. 7.3% of person-years were categorised as inappropriate SABA use and 0.9% as excessive use. Several factors were associated with lower likelihood of inappropriate use, including female sex, higher socio-economic status, higher continuity of care, having received pulmonary function test in the previous year, visited a specialist in the previous year, and the use of inhaled corticosteroids in the previous year. An asthma-related outpatient visit to a general practitioner in the previous year was associated with a higher likelihood of inappropriate SABA use. Similar associations were found for excessive SABA use with the exception that visit to respirologist and the use of systemic corticosteroids were associated with increased likelihood of excessive use.

Conclusions

Despite proven safety issues, inappropriate SABA use is still prevalent. Several factors belonging to patients’ characteristics and type/quality of care were associated with inappropriate use of SABAs and can be used to risk-stratify patients for targeted attempts to reduce this preventable cause of adverse asthma outcomes.

Download PDF

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma RT @Aller_MD: Top tips on getting through hot weather with hay fever https://t.co/ab0jHLpZBM
2hreplyretweetfavorite
Interasma RT @Aller_MD: FDA investigating unauthorized herpes vaccine research https://t.co/47Tk96Bjpb
2hreplyretweetfavorite
Interasma RT @Aller_MD: Children with low-risk penicillin #allergy symptoms who tested negative for penicillin allergy tolerated penicillin without s…
2hreplyretweetfavorite
Interasma RT @Aller_MD: By assessing the industry- and occupation-specific prevalence of asthma, this report aims to assist physicians to identify wo…
6hreplyretweetfavorite
Interasma RT @Aller_MD: Although allergies might seem a world away from mental health, a new study finds that common allergic conditions increase the…
6hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma