Late Breaking Abstract - Patterns of inhaled corticosteroid-formoterol prescriptions in Poland

Background: The Global Initiative for Asthma (GINA) 2019 report proposed novel approaches to asthma management, including using combined inhaled corticosteroid-formoterol (ICS/FOR) on an as-needed basis. This regimen provides the patient with ICS whenever reliever medication is used. Objective: This study aimed to analyze patterns of ICS/FOR prescriptions in a large group of adolescent and adult patients with asthma in Poland. Methods: We analyzed prescription database records from 5,600 pharmacies in Poland, providing information on asthma medications collected by 146,845 patients (with at least one prescription within six months) in 2018. Results: Combined ICS/ long-acting beta2-agonist (LABA) were collected by 69,497 (48%) patients, of which 28,956 (20% of ICS/LABA users) also received short-acting beta2-agonists (SABA). ICS/FOR together with SABA were collected by 10,304 (15% of all ICS/LABA) and without SABA by 18,417 (26.5% of all ICS/LABA) patients, respectively. Among patients prescribed low-dose ICS/FOR for maintenance and reliever therapy, some 6,725 (9.6% of all ICS/LABA) received SABA. Almost 1/3 of low-dose ICS/FOR patients collected fewer than four canisters of these drugs per year. Conclusions: In a large population of Polish patients with asthma, inappropriate use of SABA is common among those using low-dose ICS/FOR as maintenance and reliever therapy. ICS/FOR refill rates are low for some patients, suggesting as-needed use rather than regular maintenance as prescribed.