High Use of SABAs is Associated with Higher Exacerbation Rate in Dutch Patients with Asthma

• Main Authors: Baron AJ, Flokstra-de Blok BM, Kerstjens HAM, Koopmans-Klein G, Price DB, Sellink AA, Tsiligianni I, Kocks JWH
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-07-01
• Series: Journal of Asthma and Allergy
• Subjects: asthma; short acting beta2-agonist; saba; primary health care; adverse effects; guidelines
• Online Access: https://www.dovepress.com/high-use-of-sabas-is-associated-with-higher-exacerbation-rate-in-dutch-peer-reviewed-fulltext-article-JAA

Anna Jetske Baron,1– 3 Bertine MJ Flokstra-de Blok,1,2,4 Huib AM Kerstjens,2,3 Gineke Koopmans-Klein,5 David B Price,6,7 Andrea A Sellink,8 Ioanna Tsiligianni,9 Janwillem WH Kocks1,2,6 1General Practitioners Research Institute, Groningen, the Netherlands; 2University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, the Netherlands; 3University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, the Netherlands; 4University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, the Netherlands; 5Mundipharma Pharmaceuticals, Leusden, the Netherlands; 6Observational and Pragmatic Research Institute, Singapore; 7Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; 8AstraZeneca, Den Haag, the Netherlands; 9Health Planning Unit, Department of Social Medicine, University of Crete, Crete, GreeceCorrespondence: Bertine MJ Flokstra-de Blok Prof. E.D. Wiersmastraat 5, Groningen, 9713 GH, the NetherlandsTel [phone]Email [e-mail]: 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. The aim of this study was to describe differences in indicators of asthma symptoms and exacerbations among patients using more or less SABA than the guideline-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 categorized into 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 1 to 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 ICS-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.Keywords: asthma, short acting beta2-agonist, SABA, primary health care, adverse effects, guidelines