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Relationship between inhaled corticosteroids adherence, short-acting beta agonists use, exacerbations and self-reported asthma control.

Vervloet, M., Weesie, Y.M., Kocks, J.W.H., Dijk, L. van, Korevaar, J. Relationship between inhaled corticosteroids adherence, short-acting beta agonists use, exacerbations and self-reported asthma control. International Journal of Clinical Pharmacy: 2021, 43(1) p. 300. Abstract of the 24th annual meeting fo ESPACOMP.

ABSTRACT:

Introduction
The relationship between inhaled corticosteroids (ICS) adherence, short-acting beta agonist (SABA) use, and asthma outcomes is complex.

Aim
To investigate these relationships in a Dutch asthma patient cohort.

Methods
Patients aged C 12 years diagnosed with asthma who received C 2 inhalation medication prescriptions in 2016 were selected from Nivel Primary Care Database. This database contains information about patient characteristics, GP consultations, diagnoses and prescriptions. Adherence to ICS (implementation operationalized as Continuous Measure of medication Availability), SABA use (number of prescriptions), exacerbations (operationalized as a short course oral corticosteroids with daily dose[ 20 mg) and self-reported asthma control (measured with the Asthma Control Questionnaire; ACQ) were computed. Multilevel logistic regression analyses were used to model associations between ICS adherence, SABA use, and asthma outcomes, controlling for age, sex, comorbidity, comedication and asthma severity.

Results
Prescription data of 13,756 patients were included. ICS adherence averaged 62%. About 31% of patients received C 2 SABA prescriptions, 13% of patients experienced C 1 exacerbations in 2016. Self-reported asthma control was available for a subsample of patients (n = 2,388); 51% reported controlled asthma (ACQ score \0.75). A higher number of SABA prescriptions was associated with a higher risk of exacerbations and a higher risk of uncontrolled asthma, but also with being adherent to ICS. ICS adherence was not clearly associated with exacerbations, whilst an ICS adherence of[ 50% was associated with controlled asthma.

Conclusion
Minimizing SABA use appears to be an important strategy in reducing exacerbations and improving self-reported asthma control.