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An electronic alert to reduce excessive prescribing of short-acting beta2-agonists for people with asthma in East London: a retrospective case-control study using routine primary care data

Shauna McKibben, Andy Bush, Mike Thomas, Chris Griffiths
European Respiratory Journal 2020 56: 1364; DOI: 10.1183/13993003.congress-2020.1364
Shauna McKibben
1Asthma UK Centre for Applied Research, Queen Mary University London and Imperial College Healthcare NHS Trust, London, United Kingdom
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  • For correspondence: s.m.mckibben@qmul.ac.uk
Andy Bush
2Asthma UK Centre for Applied Research, Imperial College London, London, United Kingdom
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Mike Thomas
3Asthma UK Centre for Applied Research, University of Southampton, Southampton, United Kingdom
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Chris Griffiths
4Asthma UK Centre for Applied Research, Queen Mary University London, London, United Kingdom
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Abstract

Introduction: Computer decision support is increasingly used to reduce high-risk prescribing and improve asthma management. In 2015 an alert to identify excessive prescribing of short-acting beta2-agonists (SABAs) was introduced in EMIS Web-using practices in England. This study evaluates its effect on SABA prescribing in asthma.

Methods: Patients aged 5-75 years with asthma (coded diagnosis and one SABA prescription/12 months), prescribed excessive SABAs (3 SABAs/90 days) were included. Data was extracted from 132 general practices between 2015-2016 (cases) and 2013-2014 (controls). SABA prescribing, asthma reviews and exacerbation data was extracted. Data was adjusted for age, gender and ethnicity. Subgroup analyses included prescription type and time point.

Results: 18,244 asthma patients were prescribed excessive SABAs. In the 12 months following the alert repeat SABA prescribing reduced by 6% (ORadj 0.938, p<0.001). A reduction in SABA prescribing was associated with Black ethnicity (ORadj 0.964, p<0.001) and South Asian ethnicity (ORadj 0.972, p<0.001). The alert had no effect on exacerbations (ORadj 0.988, p=0.561). On further analysis, at 3 months following the alert asthma reviews increased by 12% (ORadj 1.120, p=0.002) and at 6 months repeat SABA prescribing reduced by 5% (ORadj 0.951, p<0.001) and exacerbations reduced by 8% (ORadj 0.924, p<0.001).

Conclusion: An alert can reduce SABA prescribing among asthma patients in primary care. A reduction appears to occur in response to an asthma review initiated following the alert rather than a change of SABA prescribing on alert presentation.

  • Primary care
  • Asthma
  • Asthma - management

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1364.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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An electronic alert to reduce excessive prescribing of short-acting beta2-agonists for people with asthma in East London: a retrospective case-control study using routine primary care data
Shauna McKibben, Andy Bush, Mike Thomas, Chris Griffiths
European Respiratory Journal Sep 2020, 56 (suppl 64) 1364; DOI: 10.1183/13993003.congress-2020.1364

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An electronic alert to reduce excessive prescribing of short-acting beta2-agonists for people with asthma in East London: a retrospective case-control study using routine primary care data
Shauna McKibben, Andy Bush, Mike Thomas, Chris Griffiths
European Respiratory Journal Sep 2020, 56 (suppl 64) 1364; DOI: 10.1183/13993003.congress-2020.1364
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