Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany

Abstract Background Overuse of short-acting beta-2 agonists (SABA), which do not treat the underlying inflammation of asthma, is linked to poor clinical outcomes such as increased exacerbation risk. This study, as part of the SABINA program, estimated the prevalence of SABA overuse and associated va...

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Main Authors: Heinrich Worth, Carl-Peter Criée, Claus F. Vogelmeier, Peter Kardos, Eva-Maria Becker, Karel Kostev, Ingo Mokros, Andrea Schneider
Format: Article
Language:English
Published: BMC 2021-04-01
Series:Respiratory Research
Subjects:
Online Access:https://doi.org/10.1186/s12931-021-01701-3
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author Heinrich Worth
Carl-Peter Criée
Claus F. Vogelmeier
Peter Kardos
Eva-Maria Becker
Karel Kostev
Ingo Mokros
Andrea Schneider
author_facet Heinrich Worth
Carl-Peter Criée
Claus F. Vogelmeier
Peter Kardos
Eva-Maria Becker
Karel Kostev
Ingo Mokros
Andrea Schneider
author_sort Heinrich Worth
collection DOAJ
description Abstract Background Overuse of short-acting beta-2 agonists (SABA), which do not treat the underlying inflammation of asthma, is linked to poor clinical outcomes such as increased exacerbation risk. This study, as part of the SABINA program, estimated the prevalence of SABA overuse and associated variables in outpatients in Germany. Methods This retrospective study used anonymized electronic healthcare data from the Disease Analyzer database (IQVIA). A total of 15,640 patients aged ≥ 12 years with asthma who received ≥ 1 SABA prescription(s) between July 2017 and June 2018 in 924 general physician and 22 pneumologist (PN) practices were included. SABA overuse was defined as ≥ 3 prescribed inhalers (~ 200 puffs each) during the study period. The associations between SABA overuse and physician specialty, Global Initiative for Asthma (GINA) steps (based on asthma medications), age, sex, and inhaled corticosteroid (ICS)/long-acting beta agonist (LABA) use were estimated using multivariable regression for patients with probable moderate (GINA step 2) and probable severe (GINA steps 3–5) asthma. Results Annually, 36% of all patients (GINA steps 1–5) in general and 38% in PN practices received ≥ 3 SABA inhalers. The risk of SABA overuse was 14% higher in patients treated by a general practitioner vs. a PN; 34% and 85% higher in GINA steps 4 and 5, respectively, vs. GINA step 3; and 40% higher in male vs. female patients. Conclusions SABA overuse is prevalent among patients with asthma across all GINA steps in Germany, which may indicate suboptimal asthma control. Further studies are needed to investigate the reasons behind SABA overuse.
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spelling doaj.art-50aa7c713c5c443aba0207600e703e2d2022-12-21T19:43:07ZengBMCRespiratory Research1465-993X2021-04-012211810.1186/s12931-021-01701-3Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in GermanyHeinrich Worth0Carl-Peter Criée1Claus F. Vogelmeier2Peter Kardos3Eva-Maria Becker4Karel Kostev5Ingo Mokros6Andrea Schneider7Facharzt Forum FürthEvangelisches Krankenhaus Göttingen-WeendeDepartment of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität MarburgLungenpraxis am Maingau KrankenhausIQVIAIQVIAAstraZeneca GmbHAstraZeneca GmbHAbstract Background Overuse of short-acting beta-2 agonists (SABA), which do not treat the underlying inflammation of asthma, is linked to poor clinical outcomes such as increased exacerbation risk. This study, as part of the SABINA program, estimated the prevalence of SABA overuse and associated variables in outpatients in Germany. Methods This retrospective study used anonymized electronic healthcare data from the Disease Analyzer database (IQVIA). A total of 15,640 patients aged ≥ 12 years with asthma who received ≥ 1 SABA prescription(s) between July 2017 and June 2018 in 924 general physician and 22 pneumologist (PN) practices were included. SABA overuse was defined as ≥ 3 prescribed inhalers (~ 200 puffs each) during the study period. The associations between SABA overuse and physician specialty, Global Initiative for Asthma (GINA) steps (based on asthma medications), age, sex, and inhaled corticosteroid (ICS)/long-acting beta agonist (LABA) use were estimated using multivariable regression for patients with probable moderate (GINA step 2) and probable severe (GINA steps 3–5) asthma. Results Annually, 36% of all patients (GINA steps 1–5) in general and 38% in PN practices received ≥ 3 SABA inhalers. The risk of SABA overuse was 14% higher in patients treated by a general practitioner vs. a PN; 34% and 85% higher in GINA steps 4 and 5, respectively, vs. GINA step 3; and 40% higher in male vs. female patients. Conclusions SABA overuse is prevalent among patients with asthma across all GINA steps in Germany, which may indicate suboptimal asthma control. Further studies are needed to investigate the reasons behind SABA overuse.https://doi.org/10.1186/s12931-021-01701-3AsthmaShort-acting beta agonistsOveruseGINARisk factorsGermany
spellingShingle Heinrich Worth
Carl-Peter Criée
Claus F. Vogelmeier
Peter Kardos
Eva-Maria Becker
Karel Kostev
Ingo Mokros
Andrea Schneider
Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
Respiratory Research
Asthma
Short-acting beta agonists
Overuse
GINA
Risk factors
Germany
title Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
title_full Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
title_fullStr Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
title_full_unstemmed Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
title_short Prevalence of overuse of short-acting beta-2 agonists (SABA) and associated factors among patients with asthma in Germany
title_sort prevalence of overuse of short acting beta 2 agonists saba and associated factors among patients with asthma in germany
topic Asthma
Short-acting beta agonists
Overuse
GINA
Risk factors
Germany
url https://doi.org/10.1186/s12931-021-01701-3
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