ArticleBMJ open2026
Identifying pharmacy medicine-dispensing patterns associated with high risk of asthma and COPD exacerbation: an Australian retrospective cohort study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine whether patterns of asthma and/or chronic obstructive pulmonary disease (COPD) medicine dispensed in pharmacy dispense records (PDRs) associated with high risk of asthma and COPD exacerbation can be identified in long-term PDRs.
designRetrospective cohort study.
settingNostraData between 2011 and 2019.
participantsDeidentified PDRs containing respiratory medicines, with a minimum of three dispensing events across at least 5 years.
main outcome measuresThe primary outcome measures were to describe the frequency, duration and dosage of medicines such as short-acting beta-agonist (SABA), oral corticosteroids (OCS) and inhaled corticosteroids (ICS), dispensed within PDRs containing respiratory medicines.
resultsOf 26 055 926 PDRs explored, 14.7% were eligible for inclusion (n=3 837 950) and represented people with a median age of 48 years who visited an average of five different pharmacies over a range of 5-8 years. The most common medicine dispensed was SABA (72.7%), and 35.2% were dispensed ≥3 in a year. Almost half the PDRs dispensed with OCS (49.2%) were dispensed ≥1 g cumulatively. Asthma and asthma/COPD PDRs were most commonly dispensed Global Initiative for Asthma (GINA) Step 4 medications (36%), and only 7.5% of PDRs demonstrated ≥60% adherence to preventer/controller inhalers.
conclusionsPatterns of medication dispensing associated with high risk of asthma and COPD exacerbation, such as the overuse of SABA and OCS and inadequate adherence to preventer/controller inhalers, can be identified in long-term PDRs. This real-time information in PDRs should be further researched to support identification of people at risk of exacerbation in primary care, to optimise management in primary care and deliver targeted intervention.
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