ASTHMA: The dangers of overuse of SABA inhalers

Asthma is a common lung disease that affects 4 million people in France and 334 million worldwide, and can cause symptoms such as coughing, wheezing and shortness of breath. Asthma is best controlled with regular use of a corticosteroid inhaler, which prevents symptoms from occurring. People with asthma can also use “SABA” rescue inhalers to quickly relieve symptoms when needed.

Working with patients to improve the use of SABA inhalers

In practice and on a daily basis, people with asthma misuse SABA inhalers, which should only be prescribed 6 times a year, and this overuse often supersedes the use of corticosteroid inhalers, ultimately resulting in poor asthma control and increased severe asthma attacks and risk promotes hospital admission.

The study based on a national (UK) review of asthma-related death data in 2014. This analysis actually identifies:

  • Evidence of overuse or even dependence on rescue inhalers in people who have died from asthma;
  • In addition, analysis of 700,000 medical records conducted in 117 general practitioner practices shows that 26% of asthma patients are still overprescribed for SABA inhalers. And among these overusers, a quarter underuse corticosteroid inhalers, which is concerning for the effectiveness of treating severe asthma;
  • Finally, the prescription of these inhalers varies significantly from one GP practice to another, with some practicing overprescribing for 6% and others for 60% of their asthma patients. Further analysis of the variability revealed that overprescribing was strongly associated with repeat prescriptions.

Prescribing these inhalers must therefore be much stricter in primary care, these researchers point out from East London, where hospital admissions for acute asthma are 14% higher than the London average. The lead author Dr. Anna De Simoni, senior author, general practitioner and professor of primary care at Queen Mary University of London, comments on these findings:

“Working with patients to improve the use of preventive inhalers must be central to reducing asthma-related hospitalizations. There’s still a lot of room for improvement.”

  • The team estimated that advising patients who use more than 12 SABA inhalers a year to reduce their use to around 4 could result in a 70 percent reduction in asthma-related hospitalizations.

“GPs and pharmacists also need to have the right tools to help patients. We plan to develop new tools to help identify and treat high-risk patients based on their prescription data.”

Leave a Comment