Observational studyBMJ open2019
Understanding reliever overuse in patients purchasing over-the-counter short-acting beta
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Adverse Outcomes Associated With Short-Acting Beta-Agonist Overuse in Asthma: A Systematic Review and Meta-Analysis.Allergy · 2025Pooled it
- Perceptions, attitudes, and behaviors of asthma patients towards the use of short-acting β2-agonists: A systematic review.PloS one · 2023Pooled it
- SABA Overuse in Russia - Burden and Possible Causes: An Analysis of the Russian Population in the SABINA III (SABA use IN Asthma) Study.Journal of asthma and allergy · 2022Trial
- Article
- Article
- Article
- Over-reliance on short-acting beta-agonists (SABAs) in asthma: a mixed method study, in primary care, in Greece.NPJ primary care respiratory medicine · 2025Article
- Influence of Saharan Dust Intrusions on Respiratory Medication Dispensing.Medical sciences (Basel, Switzerland) · 2025Article
- Guideline-driven and dependable management of asthma: an evidence-based systematic review.Annals of medicine and surgery (2012) · 2025Article
- Environmental impact of inhaled medicines: A Thoracic Society of Australia and New Zealand position statement.Respirology (Carlton, Vic.) · 2025Review
- Article
- Perceptions, practices, and experiences of asthma patients and community pharmacists on short-acting beta-2 agonists inhaler use: A qualitative study.Journal of pharmaceutical policy and practice · 2025Article
- Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products.Pragmatic and observational research · 2025Review
- Over-the-counter short-acting βNPJ primary care respiratory medicine · 2024Article
- Economic burden of short-acting beta-2 agonist (SABA) overuse among asthma patients in Türkiye: a cost analysis with respect to the updated GINA treatment recommendations.BMC pulmonary medicine · 2024Article
- Uncovering patterns of inhaler technique and reliever use: the value of objective, personalized data from a digital inhaler.NPJ primary care respiratory medicine · 2024Article
- SABA prescriptions and asthma management practices in Singapore: results from a cross-sectional, observational SABINA III study.BMJ open · 2024Observational
- Article
- Characteristics, treatment patterns and burden of illness in US patients with asthma newly initiating multiple-inhaler triple therapy.BMJ open respiratory research · 2024Article
- The Association Between Short-Acting βAdvances in therapy · 2024Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOveruse of asthma relievers is associated with significant adverse consequences. This study aimed to better understand the population purchasing and using short-acting beta agonists (SABA) over the counter (OTC); and compare the demographic, clinical and behavioural characteristics of those who overuse SABA with those who do not. DESIGN AND
settingReal-world cross-sectional observational study in community pharmacy.
participantsOf 412 participants ≥16 years requesting SABA OTC, 289 were SABA overusers (used SABA more than twice per week in the past 4 weeks).
main outcome measureReliever use, Global Initiative for Asthma-defined control, healthcare utilisation, patterns of preventer use.
results70.1% of participants were classified as SABA overusers, that is, reporting SABA use more than twice a week within the last 4 weeks, 73.6% reported not using a preventer daily and only 81.6% reported a doctor diagnosis of asthma. SABA overusers were more likely to have moderate-severe nasal symptoms (80.8% vs 63.0%, p<0.001) and a diagnosis of depression (11.1% vs 5.7%, p<0.001), when compared with SABA non-overusers. A higher proportion of SABA overusers had uncontrolled asthma (59.0% vs 15.4%, p<0.001), were more likely to use oral corticosteroids to manage worsening asthma symptoms (26.2% vs 13.5%, p<0.01) and visit the doctor for their asthma in the past 12 months (74.5% vs 62.5%, p<0.01), when compared to SABA non-overusers.
conclusionsThis study uncovers a hidden population of people who can only be identified in pharmacy with suboptimal asthma, coexisting rhinitis, poor preventer adherence and, in some cases, no asthma diagnosis.
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