(102) The Management of Adult Asthma: An Observational Study into Real-World Prescription Patterns of Inhalation Medication

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 776

Presenting Author(s)

Irene Mommers
– University of Groningen, University of Groningen, Groningen, Groningen, Netherlands

Co-Author(s)

Catharina C M Schuiling-Veninga
– Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands, Netherlands
Jens H J Bos
– Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands, Groningen, Netherlands
Job FM Van Boven, PharmD, PhD
– Assistant Professor, University Medical Center Groningen, Groningen, Groningen, Netherlands
Maarten J. Bijlsma
– Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands, Groningen, Netherlands
Eelko Hak
– Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands, Groningen, Netherlands

Background: The Global Initiative for Asthma (GINA) suggests a step-wise approach to management of asthma, including step-up if asthma is poorly controlled and step-down when possible. However, little is known about these step-up and -down regimens in clinical practice.

Objectives: To gain insight into the prescription patterns of inhalation medication in asthma patients in clinical practice.

Methods: This observational study identified new asthma patients aged ≥16 years, based on first prescription of short- or long-acting beta-agonists (SABA or LABA), inhaled corticosteroids (ICS), or a combination thereof (ICS+LABA), from the University of Groningen IADB.nl prescription database between 1994 and 2021. Treatment steps were defined as follows: 1: use of SABA or ICS-formoterol as needed, 2: low dose ICS, 3: low dose ICS plus LABA or intermediate dose ICS only, 4: intermediate to high dose ICS plus LABA, or high dose ICS only, 5: referral to a specialist. Patients’ treatment steps and switches thereof were determined over time, using dosage and time-varying proportion of days covered when necessary. Patterns were compared for gender, age and relevant comorbidities. Sensitivity analyses will be performed by excluding possible COPD cases.

Results: We identified 64056 patients. Preliminary results on a 10% sample show that 36, 32, and 20 percent of patients started treatment with SABA only, ICS plus LABA, and ICS only, respectively. LABA only, SABA plus ICS or SABA plus ICS plus LABA were less frequently prescribed as starting medication (5, 5 and 2 percent). From the four different drug categories (SABA, ICS, LABA, and ICS combined with LABA), patients used drugs from 1.85 different categories on average (IQR: 1 – 2) during their entire treatment course. This research is ongoing, and more in-depth results are expected by the 1st of July 2022.

Conclusions: The preliminary results show a great variety in the treatment of adult asthma. We expect to have results that can be compared to the GINA guidelines by July 2022.