High use of SABAs is associated with higher exacerbation rate in Dutch patients with asthma

A.J Baron; B.M.J Flokstra-de Blok; Huib AM  Kerstjens; G Koopmans-Klein; David Price; A.A Sellink; I Tsiligianni; J.W.H Kocks

doi:10.2147/JAA.S292943

High use of SABAs is associated with higher exacerbation rate in Dutch patients with asthma

A.J Baron, B.M.J Flokstra-de Blok ^* (Corresponding Author), Huib AM Kerstjens, G Koopmans-Klein , David Price, A.A Sellink , I Tsiligianni, J.W.H Kocks

^*Corresponding author for this work

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Abstract

Purpose: Many patients with asthma still have insufficient disease control, despite the availability of effective treatment options. A substantial proportion of patients appear to rely more on short-acting beta2-agonist (SABA) rather than on anti-inflammatory maintenance treatment. This study aims to describe differences in indicators of asthma symptoms and exacerbations among patients using more or less SABA than the guidelines-recommended threshold of <3 times/week.Patients and methods: Data from Dutch respondents in the European REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey were used in this post hoc analysis. The survey included asthma patients aged 18-50 years with at least two prescriptions for their asthma in the past two years. SABA use was categorizedinto two groups: <3 (low-SABA users) or ≥3 (high-SABA users) times in the last week.Results: Of the 736 asthma patients, 21% did not use SABA and 19% used SABA 1to 2 times (all low SABA users) and 60% used SABA ≥3 times (high SABA users) in the last week. The majority of high and low SABA users also reported using an ICS43 containing treatment. Significant differences were found for all indicators related to exacerbations (p<0.001): high SABA users more frequently used antibiotics and oral steroids, more frequently visited the emergency departments or needed an overnight hospital stay. Indicators of asthma symptoms were not significantly different between both groups.Conclusion: The majority of a Dutch asthmatic population reported high SABA use and had frequent moderate/severe exacerbations. More effective interventions are needed to change healthcare providers’ and patients’ behaviours to improve care and reduce SABA (over)use.

Original language	English
Pages (from-to)	851—861
Number of pages	11
Journal	Journal of Asthma and Allergy
Volume	2021
Issue number	14
Early online date	12 Jul 2021
DOIs	https://doi.org/10.2147/JAA.S292943
Publication status	Published - 12 Jul 2021

Bibliographical note

Funding
This study is funded by General Practitioners Research Institute and AstraZeneca Netherlands. The REALISE survey was funded by Mundipharma International Limited (Cambridge, UK).
Acknowledgements
We would like to thank the core study team, Thys van der Molen, Monica Fletcher, and David Price, the initial researchers of the REALISE study, for their advice on this study. We would like to thank Mundipharma Pharmaceuticals the Netherlands, for providing the data for this study.

Keywords

asthma
short acting beta2-agonist
SABA
primary health care
adverse effects
guidelines

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Cite this

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title = "High use of SABAs is associated with higher exacerbation rate in Dutch patients with asthma",

abstract = "Purpose: Many patients with asthma still have insufficient disease control, despite the availability of effective treatment options. A substantial proportion of patients appear to rely more on short-acting beta2-agonist (SABA) rather than on anti-inflammatory maintenance treatment. This study aims to describe differences in indicators of asthma symptoms and exacerbations among patients using more or less SABA than the guidelines-recommended threshold of <3 times/week.Patients and methods: Data from Dutch respondents in the European REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey were used in this post hoc analysis. The survey included asthma patients aged 18-50 years with at least two prescriptions for their asthma in the past two years. SABA use was categorizedinto two groups: <3 (low-SABA users) or ≥3 (high-SABA users) times in the last week.Results: Of the 736 asthma patients, 21% did not use SABA and 19% used SABA 1to 2 times (all low SABA users) and 60% used SABA ≥3 times (high SABA users) in the last week. The majority of high and low SABA users also reported using an ICS43 containing treatment. Significant differences were found for all indicators related to exacerbations (p<0.001): high SABA users more frequently used antibiotics and oral steroids, more frequently visited the emergency departments or needed an overnight hospital stay. Indicators of asthma symptoms were not significantly different between both groups.Conclusion: The majority of a Dutch asthmatic population reported high SABA use and had frequent moderate/severe exacerbations. More effective interventions are needed to change healthcare providers{\textquoteright} and patients{\textquoteright} behaviours to improve care and reduce SABA (over)use.",

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note = "Funding This study is funded by General Practitioners Research Institute and AstraZeneca Netherlands. The REALISE survey was funded by Mundipharma International Limited (Cambridge, UK). Acknowledgements We would like to thank the core study team, Thys van der Molen, Monica Fletcher, and David Price, the initial researchers of the REALISE study, for their advice on this study. We would like to thank Mundipharma Pharmaceuticals the Netherlands, for providing the data for this study. ",

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doi = "10.2147/JAA.S292943",

language = "English",

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TY - JOUR

T1 - High use of SABAs is associated with higher exacerbation rate in Dutch patients with asthma

AU - Baron, A.J

AU - Flokstra-de Blok , B.M.J

AU - Kerstjens, Huib AM

AU - Koopmans-Klein , G

AU - Price, David

AU - Sellink , A.A

AU - Tsiligianni, I

AU - Kocks, J.W.H

N1 - Funding This study is funded by General Practitioners Research Institute and AstraZeneca Netherlands. The REALISE survey was funded by Mundipharma International Limited (Cambridge, UK). Acknowledgements We would like to thank the core study team, Thys van der Molen, Monica Fletcher, and David Price, the initial researchers of the REALISE study, for their advice on this study. We would like to thank Mundipharma Pharmaceuticals the Netherlands, for providing the data for this study.

PY - 2021/7/12

Y1 - 2021/7/12

N2 - Purpose: Many patients with asthma still have insufficient disease control, despite the availability of effective treatment options. A substantial proportion of patients appear to rely more on short-acting beta2-agonist (SABA) rather than on anti-inflammatory maintenance treatment. This study aims to describe differences in indicators of asthma symptoms and exacerbations among patients using more or less SABA than the guidelines-recommended threshold of <3 times/week.Patients and methods: Data from Dutch respondents in the European REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey were used in this post hoc analysis. The survey included asthma patients aged 18-50 years with at least two prescriptions for their asthma in the past two years. SABA use was categorizedinto two groups: <3 (low-SABA users) or ≥3 (high-SABA users) times in the last week.Results: Of the 736 asthma patients, 21% did not use SABA and 19% used SABA 1to 2 times (all low SABA users) and 60% used SABA ≥3 times (high SABA users) in the last week. The majority of high and low SABA users also reported using an ICS43 containing treatment. Significant differences were found for all indicators related to exacerbations (p<0.001): high SABA users more frequently used antibiotics and oral steroids, more frequently visited the emergency departments or needed an overnight hospital stay. Indicators of asthma symptoms were not significantly different between both groups.Conclusion: The majority of a Dutch asthmatic population reported high SABA use and had frequent moderate/severe exacerbations. More effective interventions are needed to change healthcare providers’ and patients’ behaviours to improve care and reduce SABA (over)use.

AB - Purpose: Many patients with asthma still have insufficient disease control, despite the availability of effective treatment options. A substantial proportion of patients appear to rely more on short-acting beta2-agonist (SABA) rather than on anti-inflammatory maintenance treatment. This study aims to describe differences in indicators of asthma symptoms and exacerbations among patients using more or less SABA than the guidelines-recommended threshold of <3 times/week.Patients and methods: Data from Dutch respondents in the European REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey were used in this post hoc analysis. The survey included asthma patients aged 18-50 years with at least two prescriptions for their asthma in the past two years. SABA use was categorizedinto two groups: <3 (low-SABA users) or ≥3 (high-SABA users) times in the last week.Results: Of the 736 asthma patients, 21% did not use SABA and 19% used SABA 1to 2 times (all low SABA users) and 60% used SABA ≥3 times (high SABA users) in the last week. The majority of high and low SABA users also reported using an ICS43 containing treatment. Significant differences were found for all indicators related to exacerbations (p<0.001): high SABA users more frequently used antibiotics and oral steroids, more frequently visited the emergency departments or needed an overnight hospital stay. Indicators of asthma symptoms were not significantly different between both groups.Conclusion: The majority of a Dutch asthmatic population reported high SABA use and had frequent moderate/severe exacerbations. More effective interventions are needed to change healthcare providers’ and patients’ behaviours to improve care and reduce SABA (over)use.

KW - asthma

KW - short acting beta2-agonist

KW - SABA

KW - primary health care

KW - adverse effects

KW - guidelines

U2 - 10.2147/JAA.S292943

DO - 10.2147/JAA.S292943

M3 - Article

SN - 1178-6965

VL - 2021

SP - 851—861

JO - Journal of Asthma and Allergy

JF - Journal of Asthma and Allergy

IS - 14

ER -

High use of SABAs is associated with higher exacerbation rate in Dutch patients with asthma

Abstract

Bibliographical note

Keywords

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