Short-acting bronchodilators purchase as a marker for asthma control

Abstract

Background: Administrative data has been used to quantify the amount of medication use in order to identify at-risk asthma patients. In our previous study we used short-acting beta-agonists (SABA) inhalers as a marker for asthma control.

Methods: We further analyzed patient data from the SABA inhalers study in which asthma control was classified by GINA guidelines, physician assessment and the patients overall estimation. We identified all short-acting bronchodilator purchases (SABA and anticholinergic inhalers and solutions) in the year prior to administering the questionnaire relating to asthma control, and compared inhaled and systemic steroid use.

Results: Of 241 asthma patients, 83 completed questionnaires. Using the GINA guidelines criteria, 26 were symptom controlled, 46 were partially controlled and 11 were uncontrolled. Using patients' overall impression of their asthma control, mean annual short-acting bronchodilator purchases were significantly higher in the partially controlled and uncontrolled patients (10 and 8.9 respectively) than in the controlled patients (2, p = 0.005). Most asthma patients purchase less than half of the controller medications prescribed to them.

Conclusion: When using administrative data, 3 or more -of all types of short-acting bronchodilator purchases in one year should alert the physician to evaluate asthma control and purchase alerts should notify both physicians and patients when controller consumption is low.

KEYWORDS:

• Electronic pharmacy data
• bronchodilators
• inhaled corticosteroids
• asthma control
• GINA guidelines

Acknowledgements

The authors would like to thank CHS: Dan - Petah-Tiqwa district for a research grant in support of this work; Mr. Arie Reznik, former head of information systems in CHS, Dan-Petah-Tiqwa district, and Mrs. Nurit Moyal, head of the pharmaceutical monitoring department in CHS for their expert assistance in data retrieval; and the referents for information and projects in CHS, Dan-Petah-Tiqwa district, for patients’ questionnaires administration.

Declaration of interest

Dr. Shlomi has received lecture fees and/or consultancy fees from TEVA, GSK, Rafa Laboratories, AstraZeneca, Boehringer-Ingelheim and Kamada.

All other authors have nothing to declare.