Claire D. Visser , Maaike R.A. Faay , Ayşe Özdemir , Henk-Jan Guchelaar , Martina Teichert
{"title":"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。","authors":"Claire D. Visser , Maaike R.A. Faay , Ayşe Özdemir , Henk-Jan Guchelaar , Martina Teichert","doi":"10.1016/j.rmed.2024.107723","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Short-acting β<sub>2</sub>-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.</p></div><div><h3>Objectives</h3><p>(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.</p></div><div><h3>Methods</h3><p>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 <span>SABA</span> overusing patients with a questionnaire and semi-structured interviews, supported by theoretical frameworks.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0954611124001987/pdfft?md5=fe4182cb8ae93c2027d3907eba6d3a5d&pid=1-s2.0-S0954611124001987-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Short-acting β2-agonists (SABA) overuse in asthma and patients’ perceptions for this behavior\",\"authors\":\"Claire D. Visser , Maaike R.A. Faay , Ayşe Özdemir , Henk-Jan Guchelaar , Martina Teichert\",\"doi\":\"10.1016/j.rmed.2024.107723\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Short-acting β<sub>2</sub>-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.</p></div><div><h3>Objectives</h3><p>(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.</p></div><div><h3>Methods</h3><p>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 <span>SABA</span> overusing patients with a questionnaire and semi-structured interviews, supported by theoretical frameworks.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusion</h3><p>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. 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Short-acting β2-agonists (SABA) overuse in asthma and patients’ perceptions for this behavior
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.
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.