Increasing numbers of emergency department patients have run out of their rescue inhaler

Published online: April 10, 2018

Running out of inhaled asthma medications is an important healthcare problem. Studies have shown that up to 40% of patients with asthma believed that they were taking their asthma medications when they activated an empty or nearly empty inhaler. Running out of inhaled medications results in poor disease control and emergency department (ED) visits for acute asthma. Despite the importance, no study has evaluated the changes in the run-out status of short-acting beta-agonist (SABA) inhalers (also known as rescue inhalers) in ED patients with acute asthma and their health behavior over the past decades.

In a recent article published in The Journal of Allergy and Clinical Immunology: In Practice, Goto and colleagues examined the changes in the percentage of adults with acute asthma who ran out of their SABA inhalers before presenting to the ED between 1996-1998 and 2015-2017. This study included 150 patients from the 1996-1998 data and 203 patients from the 2015-2017 data. The primary outcome was the ran-out status of SABA inhaler within 7 days before their ED visit.

Within the same three EDs in Boston, the percentage of patients who ran out of SABA inhalers increased (18% in 1996-1998 vs 26% in 2015-2017) over the 20-year period. Among the patients who ran out of their SABA inhalers, the percentage of patients who preferred the ED as the source of asthma care and prescriptions remained high (59% in 1996-1998 vs. 51% in 2015-2017). Additionally, 70% of the 2015-2017 patients reported that they had not received a written asthma action plan before their ED visit.

Between 1996 and 2017, the percentage of ED patients with acute asthma who ran out of SABA inhalers increased significantly. The increase is explained, at least partially, by the lack of a written action plan.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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