ELDERLY ASTHMA PATIENTS SPECIFICALLY AT RISK FOR HIGH ACQUISITION OF SHORT-ACTING BETA-2 AGONIST IN A REAL WORLD STUDY IN ARGENTINE PHARMACIES

Clinical Research Results Abstract Introduction and objectives: The goals of asthma treatment include good symptom control, reducing the risk of exacerbations, and lowering the mortality rate. Excessive use of short-acting b2-agonists (SABAs) is associated with poor disease control, an increased risk of severe exacerbations and mortality. The detection of patients who do not use the appropriate medication and/or with overuse of reliever medication at the pharmacy level can provide valuable information for the management of asthma. The objectives of this study were to identify at the pharmacy level patients with respiratory diseases, especially asthma, with excessive use of SABA and correlate this with age, lack of maintenance therapy and bad symptom control. Material and methods: Adult patients attending participating pharmacies in the city of Córdoba and purchasing a canister of SABA were invited to complete an anonymized questionnaire (4 multiple-choice and 3 dichotomous questions). Data collection was carried out during 12 months. A descriptive data analysis was performed and relative risks (RR) calculated.Results: A total of 268 patients participated (58% women; 44.8% elderly >60 years). 72% (n = 193) purchased SABA for the treatment of asthma or similar symptoms (=’Asthma-group’). The number of canisters acquired in one year in the Asthma-group as compared to the Asthma- plus other respiratory disease-group was similar but comparing adults (18-60y) versus elderly we saw an increase in the acquisition of >10 canisters in the elderly (RR 1.35, 95% confidence interval 1.05-1.74), p = 0.016), [figure 1-2]. Of the Asthma-group patients (all ages) 84% (n=161/193) bought excessive SABA (≥ 3 canisters per year); 63% (102/161) of the excessive buyers actually used a greater number of puffs/day in the last month, which is higher than those who only buy 1-2 SABA canisters per year (RR 5.18, 95% CI 2.19-12.28), p<0.0001) [figure 3]. When we now compare within the Asthma-group between patients aged 18-60 and elderly the maximum number of puffs/day in the last month there is hardly any difference [figure 4]. The amount of canisters used in one year in the Asthma-group patients (all ages) with medical follow-up and using or not of other medication did not present variation, however, in patients 18-60 years without medical follow-up, a trend for an increase in acquisition is seen in for 10-12 canisters/year, while acquisition >12 canisters is higher in those who do see a doctor [figure5], but numbers are small. Finally, 56% of patients with medical follow-up compared with or without other combined medication at all ages used SABA as monotherapy [figure 6].Conclusions In this real-life analysis of the acquisition of SABA in pharmacies, inadequate treatment of patients with asthma, even under treatment and medical follow-up, was identified. The use of SABA was excessive in all age groups regardless of severity and access to medical follow-up; we identified the elderly as being more prone to high SABA acquisition, which makes them specifically vulnerable, due to frequent underlying health conditions. These data merit the implementation of educational actions and work plans at all health-care levels involved in asthma. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest References and Clinical Trial Registry Information