Clinical Factors Associated With Overuse of Asthma Reliever Medication.

OBJECTIVE: Our aim was to evaluate the relationship between the clinical factors of asthma and the use of reliever medication. METHODS: We performed an observational cross-sectional study in Spain. The study population comprised patients aged ≥12 years diagnosed with persistent asthma according to the criteria of the Global Initiative for Asthma and receiving maintenance treatment for at least 12 months. Use of reliever medication was classified as low use of reliever medication (LURM) (≤2 times/wk) and high use of reliever medication (HURM) (≥3 times/wk). A variety of clinical variables and patient-reported outcomes (PROs) were recorded (eg, scores on the Asthma Control Questionnaire-5 [ACQ-5] and Test of Adherence to Inhalers [TAI]). RESULTS: A total of 406 patients were recruited. Mean (SD) age was 44.3 (17.9) years, and 64% were women. Reliever medication was used ≤2 times/wk in 76.1%. Bivariate analysis showed that HURM was related to smoking habit, unscheduled emergency department visits, hospital admissions, higher doses of inhaled corticosteroid, and night awakenings in the previous 4 weeks (P<.001). The multivariate analysis showed a higher risk of using reliever 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 the ACQ-5. CONCLUSIONS: Our study identifies the potential of poor use of reliever medication in the last week as an alarm signal for disease-related parameters such as exacerbations, poor asthma control, and disease severity.

Clinical factors associated with overuse of asthma reliever medication

OBJECTIVE: Our aim was to evaluate the relationship between the clinical factors of asthma and the use of reliever medication. METHODS: We performed an observational cross-sectional study in Spain. The study population comprised patients aged ≥12 years diagnosed with persistent asthma according to the criteria of the Global Initiative for Asthma and receiving maintenance treatment for at least 12 months. Use of reliever medication was classified as low use of reliever medication (LURM) (≤2 times/wk) and high use of reliever medication (HURM) (≥3 times/wk). A variety of clinical variables and patient-reported outcomes (PROs) were recorded (eg, scores on the Asthma Control Questionnaire-5 [ACQ-5] and Test of Adherence to Inhalers [TAI]). RESULTS: A total of 406 patients were recruited. Mean (SD) age was 44.3 (17.9) years, and 64% were women. Reliever medication was used ≤2 times/wk in 76.1%. Bivariate analysis showed that HURM was related to smoking habit, unscheduled emergency department visits, hospital admissions, higher doses of inhaled corticosteroid, and night awakenings in the previous 4 weeks (P<.001). The multivariate analysis showed a higher risk of using reliever 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 the ACQ-5. CONCLUSIONS: Our study identifies the potential of poor use of reliever medication in the last week as an alarm signal for disease-related parameters such as exacerbations, poor asthma control, and disease severity

OBJETIVO: Nuestro objetivo fue evaluar la relación entre parámetros clínicos del asma y el uso de medicación de rescate. MÉTODOS: Estudio observacional de corte transversal realizado en España. El estudio reclutó pacientes ≥12 años diagnosticados con asma persistente según los criterios de GINA y que recibieron tratamiento de mantenimiento durante al menos 12 meses. El uso de la medicación de rescate fue dicotomizado: bajo uso de medicación de rescate (LURM) (≤dos veces/semana) o alto uso de medicación de rescate (HURM) (≥tres veces/semana). Se registraron una variedad de variables clínicas y resultados notificados por los pacientes (PRO), como el Cuestionario de Control del Asma-5 (ACQ-5) y la Prueba de Adherencia a Inhaladores (TAI). RESULTADOS: Se reclutaron 406 pacientes, de 44,3 [17,9] años edad media (DE) y un 64% de mujeres. En el 76,1% se utilizó medicación de rescate ≤dos veces por semana. El análisis bivariante mostró que la HURM estaba relacionada con el hábito de fumar, las visitas no programadas a urgencias, ingresos hospitalarios, aumento de las dosis de corticosteroides inhalados, aumento en la terapia y los despertares nocturnos en las últimas cuatro semanas (p < 0,001). El análisis multivariado mostró un mayor riesgo de usar medicación de rescate en fumadores y exfumadores, cuando aumentó el número de despertares nocturnos, en casos de autopercepción de asma parcialmente controlada o no controlada, o cuando el asma no está controlada en base al ACQ-5. CONCLUSIONES: Nuestro estudio identifica la posibilidad de utilizar el aumento de la medicación de rescate en la última semana como una señal de alarma para algunos parámetros de la enfermedad, como exacerbaciones, mal control del asma y gravedad de la enfermedad