TY - JOUR T1 - Reducing short-acting beta-agonist overprescribing in asthma: lessons from a quality-improvement prescribing project in East London JF - British Journal of General Practice JO - Br J Gen Pract SP - e619 LP - e626 DO - 10.3399/BJGP.2021.0725 VL - 72 IS - 722 AU - Anna De Simoni AU - Hajar Hajmohammadi AU - Paul Pfeffer AU - Jim Cole AU - Chris Griffiths AU - Sally A Hull Y1 - 2022/09/01 UR - http://bjgp.org/content/72/722/e619.abstract N2 - Background Excess prescription and use of short-acting beta-agonist (SABA) inhalers is associated with poor asthma control and increased risk of hospital admission.Aim To quantify the prevalence and identify the predictors of SABA overprescribing.Design and setting A cross-sectional study using anonymised clinical and prescribing data from the primary care records in three contiguous East London boroughs.Method Primary care medical record data for patients aged 5–80 years, with ‘active’ asthma were extracted in February 2020. Explanatory variables included demography, asthma management, comorbidities, and prescriptions for asthma medications.Results In the study population of 30 694 people with asthma, >25% (1995/7980), were prescribed ≥6 SABA inhalers in the previous year. A 10-fold variation between practices (<6% to 60%) was observed in the proportion of patients on ≥6 SABA inhalers/year. By converting both SABAs and inhaled corticosteroids (ICSs) to standard units the accuracy of comparisons was improved across different preparations. In total, >25% of those taking ≥6 SABAs/year were underusing ICSs, this rose to >80% (18 170/22 713), for those prescribed <6 SABAs/year. Prescription modality was a strong predictor of SABA overprescribing, with repeat dispensing strongly linked to SABA overprescribing (odds ratio 6.52, 95% confidence interval = 4.64 to 9.41). Increasing severity of asthma and multimorbidity were also independent predictors of SABA overprescribing.Conclusion In this multi-ethnic population a fifth of practices demonstrate an overprescribing rate of <20% a year. Based on previous data, supporting practices to enable the SABA ≥12 group to reduce to 4–12 a year could potentially save up to 70% of asthma admissions a year within that group. ER -