Therapeutic behavior patterns and its association with disease control outcomes in asthma. A descriptive real-life cohort study

Clinical Research Results Abstract Introduction: Non-compliance with inhaled-glucocorticosteroids (ICS) asthma treatment induces poor disease control. Many patients excessively rely on Short Acting Beta-Agonists (SABA) as asthma rescue medication. SABA misusage has been associated with uncontrolled disease, hospitalization, increased healthcare costs and mortality.Objective: To identify the association of patterns of SABA and ICS usage with health-related outcomes, including number of asthma hospitalizations or work productivity loss.Methods: Retrolective descriptive study with prospective follow-up of the anonymous MAJORICA population cohort for 4 years (2015-2019). Two-stage cluster analysis was performed to determine the greatest classifying power and interpretation clarity. Behavior patterns regarding SABA and ICS consumption were identified and association between the identified clusters and health-related outcomes was analyzed.Results: 11975 over 18 asthma patients on inhaled treatment and at least one ICS prescription during the period, with no COPD or other severe pulmonary disease were included. Median age 46yo; 65% women. SABA abusers below 80% prescribed maintenance medication retired from pharmacy and rescue medication abuse (cluster4) presented higher risk for asthma hospitalization OR 2.65 (1.63–4.30) than those below 80% of prescribed maintenance medication retired from pharmacy and no evidence for rescue medication abuse. Hyper-medicated patients (cluster2) presented slightly lower OR 2.27 (1.50–3.42) for hospitalization. Patients correctly medicated, with over 80% prescribed maintenance medication retired and no evidence for rescue medication abuse (cluster1) also had a slight but significant increased risk of hospitalization. Older age, female sex, and smoking were independently associated with asthma hospitalization. Only smoking was identified as a risk factor for work productivity loss due to asthma. (Table1)Discussion: Patients retiring over 80% prescribed maintenance medication in a 4-year period had worse health outcomes than those retiring less than 80%. This cluster could identify more severe and symptomatic asthma patients. SABA overuse increases risk for asthma hospitalization independently of ICS use. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Declaration of interest: Astrazeneca grant References and Clinical Trial Registry Information