Short-Acting Beta Agonists Dispensed

Description:

Our short-acting beta agonist use (dispensed) measure uses claims data to determine the percentage of patients in our population (Adult Asthma, Pediatric Asthma, and COPD) who were identified as having asthma or COPD with 0-2, 3-5, or 6 or more SABA inhaler medication fills in the measurement year.  A lower percentage of patients with three or more fills indicated better performance.

Population Specifics:

• Asthma patients, regardless of severity, aged 5 years and older.
• COPD patients aged 40 years and older.

Numerator/Denominator

• Denominator: Eligible patients, as defined above, with at least one prescription claim in the measurement year.
• Numerator: Eligible patient included in the denominator for whom a SABA inhaler medication is dispensed 0-2, 3-5, or 6+ time in the measurement year.

Rationale:

• COPD (GOLD 2023):
  • “Use of short acting bronchodilators on a regular basis is not generally recommended” (Pg. 56).
  • “Combining SABA and SAMA’s are superior compared to either medication alone in improving FEV1 and symptoms” (Pg.. 59).
  • LABAs and LAMAs are preferred over short-acting agents except for patients with only occasional dyspnea, and for immediate relief of symptoms in patients already on long-acting bronchodilators for maintenance therapy” (Pg. 114).
  • See page 115 of the GOLD 2023 Full Report for Pharmacological Treatment recommendations.
• Asthma (GINA 2022):
  • SABA overuse (3 or more 200-dose canisters /year) increases risk for exacerbations; substantial increases in mortality if 1 or more canisters filled per month. (Pg. 14).
  • “There is strong evidence that SABA-only treatment, although providing short-term relief of asthma symptoms, does not protect patients from severe exacerbations, and that regular or frequent use of SABA increases the risk of exacerbations” (Pg. 18).
  • “Although SABA provides quick relief of symptoms, SABA-only treatment is associated with increased risk of exacerbations and lower lung function. Regular use of SABA increases allergic responses and airway inflammation, and reduces the bronchodilator response to SABA when it is needed. Overuse of SABA (3 or more 200-dose canisters dispensed in a year) is associated with an increased risk of severe exacerbations. Dispensing 12 or more SABA canisters in a year (and possibly even less than this) is associated with increased risk of asthma-related death” (Pg. 19). 

Guideline Links:

• GOLD 2023 Guidelines: 2023 GOLD Report 
• GINA 2022 Guidelines: 2022 GINA Main Report 
• GINA 2023 Guidelines: 2023 GINA Main Report