Clinical factors associated with the overuse of asthma rescue medication

I Urrutia, J Delgado, J Domínguez-Ortega, E Mascarós, M Pérez, G Resler, V Plaza
Journal of Investigational Allergology & Clinical Immunology 2019 February 11

BACKGROUND AND OBJECTIVE: Our aim was to evaluate the relationship between asthma clinical factors and use of relief medication.

METHODS: This was an observational cross-sectional study conducted in Spain. The study recruited patients ≥ 12 years of age diagnosed with persistent asthma according to the GINA criteria and receiving maintenance treatment for at least 12 months. Use of relief medication was dichotomized: low use of rescue medication (LURM) (≤ twice/week) or high use of rescue medication (HURM) (≥ three times/week). A variety of clinical variables and patient reported outcomes (PROs) such as the Asthma Control Questionnaire-5 (ACQ-5) and Test of Adherence to Inhalers (TAI) were recorded.

RESULTS: A total of 406 patients were recruited, mean (SD) age 44.3(17.9) years and 64% women. In 76.1% rescue medication was used ≤ twice/week. Bivariate analysis showed HURM was related to smoking habit, unscheduled emergency room visits, hospital admissions, increased inhaled corticosteroid doses, therapeutic upgrading and night awakenings in the last four weeks (p<0.001). The multivariate analysis showed a higher risk of using relief medication in smokers and former smokers, when the number of night awakenings increased, in cases of self-perception of partially controlled or uncontrolled asthma, or when asthma is uncontrolled according to ACQ-5.

CONCLUSIONS: Our study identifies the potential of using abuse of rescue medication in the last week as an alarm signal for disease parameters such as exacerbations, poor asthma control and disease severity.

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