Late Breaking Abstract - Overprescription of short-acting beta2-agonists in asthma management? Pharmacy reports from 91,673 patients in Poland

Background: Frequent SABA use is associated with a higher risk of exacerbations and asthma-related death. Therefore, restriction of SABA use is proposed in the GINA 2019 report. Objectives: This study aimed to investigate patterns of SABA use in asthma management in Poland. Methods: We analyzed prescription records from 5,600 pharmacies, focusing on adult patients receiving asthma medications in 2018. Results: Of the 91,673 patients aged 18–64 years included, 5,202 (5.7%) represented SABA-only, 5,961 (6.5%) inhaled corticosteroid (ICS), 7,197 (7.9%) long-acting beta2-agonist (LABA), and 73,313 (80%) ICS/LABA treatment. Concomitant SABA prescriptions were apparent for 100% of ICS patients (5,961) and 40% of ICS/LABA users (29,289). Three or more SABA canisters per year were collected by 29% (1,730) of patients in the ICS group, and 37% (10,749) in the ICS/LABA group. Some 5.6% (2,359) of SABA users received 12 or more SABA canisters per year. SABA prescriptions were issued mostly by general practitioners (75% in the SABA-only group, 60% in the ICS group, and 59% in the ICS/LABA group), followed by pulmonologists (5%, 13%, and 19%, respectively) and allergists (35%, 9%, and 10%, respectively). Conclusions: SABA usage is probably not recognized as a sign of poor asthma control in Poland. SABA overuse (≥3 canisters per year) was observed in about one-third of ICS or ICS/LABA-treated individuals, thus representing potentially higher risk of exacerbations.