Suboptimal asthma control among over-the-counter reliever purchasers in the community pharmacy

Background: Overuse of short-acting beta agonist (SABA) reliever medication is a significant problem globally, and is associated with significant adverse consequences in asthma patients. Attitudes and perceptions of asthma patients using relievers in countries where it is available over-the-counter (OTC) is unknown. The study aimed to compare the attitudes, perceptions, medication knowledge and information gathering behaviour of people with asthma who overuse SABA (GINA) compared with those who do not. Method: A real-world cross-sectional observational study among people with asthma purchasing OTC SABA medication from community pharmacies across various geographical and socio-demographic regions in Australia between October 2017 to October 2018. Data were collected using a structured self-administered questionnaire within the pharmacy setting. Results: Of the 375 participants with asthma aged ≥ 16 years, 73.9% were classified as SABA over users, 90.4% reported that their asthma was controlled and 56.0% felt that it was not serious; however only 17.6%, had controlled asthma according to GINA-defined criteria. While 68.0% of SABA over users were instructed to take preventer medication every day by a physician, 73.6% were non-adherent to preventer medication and 49.8% had concerns about taking regular preventer medication. SABA over users were more likely to feel embarrassed carrying and using their asthma inhaler compared to non-over users. Conclusion: This is research is one of the first to explore differences in perception and medication usage between SABA over users and non-over users. It has uncovered a need to better understand patient perceptions and their relationships to SABA over use and prevented underuse.