Asthma patients in US overuse quick-relief inhalers, underuse control medications

Published Online: December 13, 2013

Asthma exacerbations and uncontrolled asthma result in poor health outcomes. Patients with well-controlled asthma are at lower risk for exacerbations. Therefore, asthma control is the goal of asthma management for patients and a focus for research and intervention. Asthma control is signaled by frequency of symptoms, need for quick-relief medications, and number of exacerbations requiring oral corticosteroids (among others).

In an original research paper recently published in The Journal of Allergy & Clinical Immunology (JACI), Slejko et al aimed to explore broad patterns of asthma prevalence, self-reported medication use, and indicators of control in a sample of patients representative of the US asthma patient population. The study authors analyzed responses of 102,544 individuals of the US Medical Expenditure Panel Survey (combined years 2008-2010) to examine the national prevalence of self-reported asthma, trends in medication use, and demographic characteristics of asthmatic patients. Individuals surveyed were asked about their asthma history, current diagnosis, use of medications, and history of asthma exacerbations.

Of the individuals surveyed, 9,782 individuals reported lifetime asthma and 8,837 reported current asthma. About half of these patients used a quick-relief inhaler for asthma symptoms, and about 15% used more than 3 canisters of this type of medication in the past 3 months. Of this group, 60% were using daily control medications, whereas 28% had never used long-term control medication. Of those who had a recent exacerbation, 29% were using daily preventive medication, whereas 54% had never used long-term control medication.

Asthma control in US patients appears to be suboptimal. Long-term control medications are used in only about half of the asthmatic patients for whom they are recommended. At the same time, quick-relief inhalers are used at a level that would signify very poorly controlled asthma. Patients and healthcare providers might discuss their perceived benefit from, effectiveness of, and access to long-term control medications.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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