Short-acting β2-agonists (SABA) overuse in asthma and patients’ perceptions for this behavior

IF 3.5 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Respiratory medicine Pub Date : 2024-06-25 DOI:10.1016/j.rmed.2024.107723
Claire D. Visser , Maaike R.A. Faay , Ayşe Özdemir , Henk-Jan Guchelaar , Martina Teichert
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引用次数: 0

Abstract

Background

Short-acting β2-agonists (SABA) overuse is associated with poor asthma control. The Global Initiative for Asthma (GINA) 2019-updated strategy report has therefore taken a paradigm shift in reliever therapy recommendations.

Objectives

(I) To investigate the status of SABA overuse and medication dispensing patters in asthma in the Netherlands (II) validate dispensing data for SABA overuse identification and (III) understand patients’ perspectives towards this SABA-taking behavior to inform future improvement strategies.

Methods

An annually repeated cross-sectional study was conducted from 2017 to 2021 using pharmacy dispensing data in a real-world setting, including asthma patients aged 18–45 with ≥1 inhaler. A following qualitative study was performed in identified SABA overusing patients with a questionnaire and semi-structured interviews, supported by theoretical frameworks.

Results

Dispensing data was available from 87 % of all community pharmacies (n = 1994) in 2017 and 95 % (n = 2005) in 2021. SABA overuse prevalence was constant for the five study-years with 20.6 % (±0.5 %). Increased ICS-formoterol and decreased SABA dispenses were observed in starters of inhalation therapy in 2021. 53 asthma patients completed the questionnaire of whom 43 patients confirmed SABA overuse, generating a positive predictive value of 81 %. Key behavioral drivers covered 7 themes regarding capability (knowledge; skills; memory, attention and decision process) motivation (emotion; beliefs about-capabilities; consequences) and opportunity (environmental context).

Conclusion

SABA overuse remains in one-fifth of asthma patients across the Netherlands, requiring careful attention from healthcare professionals. Dispensing data is a valid measure for SABA overuse in a clinical setting, facilitating patient selection. To meet patients’ varied supporting needs, integration of tailored behavioral interventions is essential.

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哮喘患者过度使用短效β2-激动剂(SABA)及患者对此行为的看法。
背景:短效β2-激动剂(SABA)的过度使用与哮喘控制不佳有关。因此,全球哮喘倡议(GINA)2019年更新指南在缓解剂治疗建议方面采取了范式转变。目的:(I)调查荷兰哮喘患者SABA过度使用的状况和配药模式(II)验证配药数据以识别SABA过度使用的情况;(III)了解患者对这种服用SABA行为的看法,为未来的改进策略提供依据:在 2017-2021 年期间,利用真实世界环境中的药房配药数据开展了一项每年重复的横断面研究,研究对象包括年龄在 18-45 岁且吸入器数量≥ 1 个的哮喘患者。随后,在理论框架的支持下,通过问卷调查和半结构式访谈对确定的SABA过度使用患者进行了定性研究:2017年,87%的社区药房(n=1,994)提供了配药数据,2021年,95%的社区药房(n=2,005)提供了配药数据。在五个研究年度中,SABA 过度使用率保持不变,均为 20.6% (±0.5%)。在 2021 年的吸入疗法启动者中,观察到 ICS-福莫特罗的配药量增加,SABA 的配药量减少。53 名哮喘患者完成了问卷调查,其中 43 名患者确认过度使用 SABA,阳性预测值为 81%。关键行为驱动因素包括7个主题,涉及能力(知识、技能、记忆、注意力和决策过程)、动机(情绪、对能力的信念、后果)和机会(环境背景):结论:荷兰全国仍有五分之一的哮喘患者过度使用 SABA,需要医疗保健专业人员认真对待。配药数据是在临床环境中衡量 SABA 过度使用的有效指标,有助于选择患者。为满足患者不同的支持需求,整合量身定制的行为干预措施至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Respiratory medicine
Respiratory medicine 医学-呼吸系统
CiteScore
7.50
自引率
0.00%
发文量
199
审稿时长
38 days
期刊介绍: Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.
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