SABA and ICS use among mild asthma patients in UK primary care

Abstract

Introduction: Some mild asthma patients are thought to be poorly controlled due to over-reliance on short-acting beta-agonist (SABA), and underuse of inhaled corticosteroid (ICS). We describe SABA and ICS use in a UK population. Methods: Using UK electronic healthcare data (CPRD) we identified mild asthma patients, ≥12 years old, 2008 to 2016; defined as prescribed SABA +/- low dose ICS (≤799mcg beclometasone equivalent as per the BTS/SIGN British asthma guidelines). SABA was categorised by number of inhalers/year. ICS was defined as mean-daily-dose/year (beclomethasone equivalent); year-to-year increases/decreases were defined as ≥200mcg. Results: 373,256 mild asthma patients were identified. During the study period the approximate percentage of patients prescribed SABA were: ≤1 inhaler/year=60%, 2 inhalers/year=10%, 3-6 inhalers/year=15%, 7-12 inhalers/year=8%, ≥13 inhalers/year=2% (see Figure). There was little temporal change in the proportion of patients in each category. For patients only prescribed SABA, there was around a 10% change year-to-year between SABA categories. In patients prescribed ICS and SABA, there was around 25% change year-to-year between SABA categories. In contrast, Conclusion: There was considerably more variability year-to-year in SABA than ICS prescribing, suggesting SABA use is changed rather than ICS in response to changes in asthma control.