Over-reliance on SABAs

In the UK, SABA over-reliance is a problem

The National Review of Asthma Deaths (NRAD) provided evidence of excessive prescribing of SABAs.4

In the year prior to death SABA prescribing data was available for 165 patients:4

  • 56% (92/165) had been prescribed >6 SABA inhalers
  • 39% (65/165) had been prescribed >12 SABA inhalers
  • 4% (6/165) had been prescribed >50 SABA inhalers

Following NRAD, a subsequent review of 50 GP practices in Bedfordshire identified a median of 5.2% (range: 1-14%) of all asthma patients per practice had been prescribed >12 SABA inhalers in the previous year.5

Preventable asthma attacks still occur across all disease severities

Asthma attacks continue to affect patients across all symptom severities.6,7 Despite the availability of effective treatments, however, poor asthma control puts patients at risk of an asthma attack.8,9

People with asthma tend to rely too much on their Short Acting Beta Agonist (SABA)

When their asthma symptoms worsen, most people simply increase their use of SABA.10-12 Unfortunately, this over-reliance on SABA is often at the expense of their maintenance treatment.12 Over-reliance on SABAs may leave patients at risk of a preventable asthma attack.8,12,13

SABAs don’t address the underlying asthma problem

As you can see from the visual, SABAs, as bronchodilators, provide rapid but only temporary symptom relief as a rescue therapy.14

The recommended treatment approach is regular inhaled corticosteroid (ICS) which treats the inflammation – the underlying cause of asthma symptoms.15

SABAs don’t address the underlying asthma problem
SABAs don’t address the underlying asthma problem

Complacency about excessive SABA use

Despite current evidence, it has been found that clinicians are complacent about excessive SABA use.5,16

A couple of simple questions about your patients’ SABA habits could see whether they are relying too much on their SABA, and if you need to act:17

Question 1: How often have your patients used their SABA in the past 4 weeks?

Using a SABA three times a week or more could be a sign of poor control.17

Question 2: How many SABA inhalers have your patients used this year?

Patients should not need to use more than two SABA inhalers per year as those who do are at an increased risk of asthma attacks.16

ICS: inhaled corticosteroid; NRAD: National Review of Asthma Deaths; SABA: short acting beta-agonist.