SABA overreliance and physician visits in Canada

Abstract

Background: Inhaled corticosteroids (ICS) are a treatment foundation of asthma. Patients may also use short acting beta-2 agonists (SABA) to relieve symptoms but SABA alone does not treat the underlying inflammation. Thus, overreliance on SABA may result in poor asthma control and higher health resource utilization (HRU). Objective: To describe the use of SABA and ICS, and characterize the relationship to HRU in Nova Scotia, Canada, from Oct 2016-Mar 2019. Methods: In this Canadian SABINA (SABA In Asthma) study (Cabrera CS, Eur Respir J 2020), individuals with ≥1 inpatient or ≥2 asthma-related outpatient visits and ≥12 months’ follow-up were identified within an administrative dataset (Health Data Nova Scotia). Poisson regression was used to determine the relationship between SABA use and outpatient visits, adjusted for age and sex. Results: A total of 5,295 patients were identified (mean age 41.7 (SD: 18.4)). Of these, 32.7% (95% CI: 30.4-35.0%) of patients with at least one claim for ICS and 27.8% (26.3-29.3%) of patients with no claims for ICS made ≥3 SABA claims/ year. Asthma-related outpatient visits increased significantly with number of SABA canisters used per year (p Conclusion: These data highlight the continued impact of SABA overreliance in Canada. These results support the GINA 2019 statement on the impact of SABA overreliance leading to increased HRU.