Reducing short acting beta agonist overuse in the asthma population

Abstract Rationale Excessive use of inhaled short acting beta agonists is associated with increased ER visits, hospitalizations and risk of death in the asthmatic population. Albuterol overuse is preventable with appropriate long-term control therapy. The National Institutes of Health (NIH) guidelines recommends inhaled corticosteroids (ICS) as the most effective long-term therapy for asthma control. Methods Beta agonist overuse (BAO) was defined as ≥6 albuterol canister equivalents in a 6 month period. Through pharmacy data, Asthma Care Managers reviewed patients (ages 5-56) with a documented diagnosis of asthma, who met BAO criteria. Patients were contacted by phone to verify information, evaluate asthma control, assess educational needs and facilitate appropriate care and treatment based on NIH guidelines. The BAO population and current prescription fills of ICS were measured prior to intervention and at 2, 4 and 6 months post intervention. Results At 4 months post intervention, results indicated a >50% reduction of the BAO population. The population with a current prescription fill of ICS went from 42% at baseline to 75%. Additional data will be available in 2004. Conclusions Interventions have shown effectiveness in reducing the beta agonist overuse population and increasing the use of ICS. We anticipate the interventions will improve clinical outcomes by reinforcing compliance with appropriate long-term therapies, while discouraging reliance on albuterol as sole asthma therapy. This project also provides feedback, education and ongoing prescription pattern information to primary care providers. These actions should reinforce the appropriate prescribing patterns for persistent asthmatics among primary care providers.