PRS4 SABA OVERUSE AND HEALTH CARE RESOURCE UTILIZATION IN A NATIONWIDE SWEDISH ASTHMA COHORT (HERA)

Abstract

Short-acting beta2-agonists (SABA) are used as reliever therapy in asthma, and over-reliance on SABA is a marker of uncontrolled asthma. This study assessed the association between SABA use and health care resource use in a general asthma population in Sweden. We identified 365,324 patients with asthma aged 12–45 years from national registers. Asthma status was defined as collection of ≥2 drugs for obstructive lung disease in any 12-month period during 2006-2014 (date of inclusion was 2nd collection date). SABA over-reliance was defined as >2 SABA canisters in a 12-month baseline period following inclusion. Patients that were over-reliant on SABA were further grouped as 3-5, 6-10, or ≥11 canisters/year. Health care resource use was defined as rates of total and asthma-related hospitalization and outpatient visits. Mean age of patients was 27.6 years; 55% were women. Thirty percent of patients were over-reliant on SABA: 21% collected 3-5; 7% 6-10; and 2% ≥11 canisters/year. Patients over-reliant on SABA and those who were not over-reliant were similar in relation to age, gender, and co-morbidities. Patients over-reliant on SABA had more exacerbations (29.8 per/1000 patient-years (PY) vs 17.6), total hospitalizations (62.4 per/1000 PY vs 48.3), asthma-related hospitalizations (4.6 per/1000 PY vs 1.0), total outpatient visits (587.5 per/1000 PY vs 507.1), and asthma-related outpatient visits (209.4 per/1000 PY vs 132.1) than patents who were not over-reliant on SABA. Higher numbers of SABA canisters collected was associated with higher rates of hospitalizations and outpatient visits. In this nationwide asthma population, up to 30% of patients were over-reliant on SABA. These patients were at greater risk for hospitalization and outpatient visits than those who were not over-reliant on SABA. Improved outpatient follow-up of patients over-reliant on SABA may help to reduce the rates of hospitalizations for asthma.