ASTHMA CONTROL EVALUATED WITH ELECTRONIC MEDICATION MONITOR (EMM)-DEFINED OCCASIONS OF SHORT-ACTING BETA-AGONIST INHALER USE

Abstract

Introduction The Global Initiative for Asthma (GINA) and National Heart Lung and Blood Institute Expert Panel-3 (EPR-3) guidelines quantify short-acting beta-agonist (SABA) use in their assessment of asthma control. Both define control by the number of SABA uses/week, but neither defines the duration for each “occasion” of use. Utilizing EMMs, we compared estimates of asthma control using GINA and EPR-3 criteria based on 3 potential occasion definitions of SABA. Methods Data were collected from 5,067 adults from 2015-2017 with self-reported asthma and an EMM-equipped SABA inhaler to passively collect time and date of SABA actuations. For GINA, partly controlled (PC) asthma was use >2 times/week. For EPR-3, not well-controlled (NWC) was use >2 days/week, and very poorly controlled (VPC) was use several (≥3) times a day. Using EMMs, 3 occasions of SABA use were studied as ≥1 puff of SABA within 2-, 4- or 6- hour durations. This study was exempted from IRB approval. Results Both GINA and EPR-3 criteria identified 34-37% of patients as PC or NWC irrespective of occasion definition. Among those NWC based on EPR-3 criteria, the prevalence of VPC was 50%, 44% and 32% with 2-, 4- or 6-hour occasions, respectively. Conclusions The prevalence of very poorly controlled asthma varied by the duration of an occasion. Standardized definitions of an occasion and collection of SABA data with EMMs should be harmonized to more accurately assess asthma control and identify patients who may need modifications in controller therapy to achieve optimal control.