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• W4311698534 abstract "<h3></h3> Inappropriate use of inhalers (due to suboptimal adherence or prescribing) is associated with adverse outcomes in asthma. Despite this, patterns of inhaler prescribing and adherence are not routinely assessed on admission. This could lead to inappropriate treatment escalation and missed opportunities for patient education. To evaluate the feasibility and potential impact of a routine adherence report we collected data on primary care prescription issue over the previous year in 95 consecutive patients admitted with asthma using electronic records. The medication possession ratio (MPR) for preventer medication was calculated; a cut off of 75% considered sub-optimal adherence. The numbers of prescribed short-acting β2-agonist inhalers and oral corticosteroids were also recorded. Results were retrospectively reviewed for each patient alongside discharge medication to determine whether knowledge of adherence on admission would have identified inappropriate prescribing, better inform patient education, or may have prevented unnecessary treatment escalation. Adherence reports were completed for 84/95 (88.4%) patients (one died before discharge, 10 had inaccessible records). 29 patients had first been prescribed preventer medication during the current exacerbation (on or just before admission). Of these 18 had received ≥ 1 SABA prescription during the previous year, 11 of whom had evidence of a historical blood eosinophilia suggesting missed opportunities for ICS prescribing in at least 37.9%. Of the 55 patients taking preventer medication prior to the current exacerbation, 36 (65.5%) had suboptimal adherence; 10 of whom had their ICS dose increased on discharge, suggesting inappropriate treatment escalation in 27.8%. 42 patients had been prescribed excessive SABA (at least 3 inhalers a year, including 10 of those with optimal adherence to preventer medication). Overall, this suggests that the adherence report identified areas for patient education in 83.6% of those who had already been established on preventer medication. Patients with MPR <0.75 had a significantly shorter length of stay (1.3 v 2.7 days, p=0.01) suggesting less severe exacerbations which may have been prevented by improved adherence. A comprehensive asthma prescribing and adherence report is feasible for patients admitted with acute severe asthma, and is likely to improve patient education and appropriate prescribing in the majority." @default.
• W4311698534 created "2022-12-28" @default.
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• W4311698534 date "2022-11-01" @default.
• W4311698534 modified "2023-10-17" @default.
• W4311698534 title "P185 Comprehensive assessment of inhaler prescribing and adherence in patients admitted to hospital with acute severe asthma may improve management" @default.
• W4311698534 doi "https://doi.org/10.1136/thorax-2022-btsabstracts.319" @default.
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