Metrics of salbutamol use as predictors of future adverse outcomes in asthma
Background Beta-agonist overuse is associated with adverse outcomes in asthma, however, the relationships between different metrics of salbutamol use and future risk are uncertain. Objective To investigate the relationship between metrics of salbutamol use and adverse outcome. Methods In...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
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Wiley
2013
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| Online Access: | https://eprints.nottingham.ac.uk/42812/ |
| _version_ | 1848796573932191744 |
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| author | Patel, Mitesh Pilcher, Janine Reddel, Helen K. Pritchard, Alison Corin, Andrew Helm, Colin Tofield, Christopher Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard |
| author_facet | Patel, Mitesh Pilcher, Janine Reddel, Helen K. Pritchard, Alison Corin, Andrew Helm, Colin Tofield, Christopher Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard |
| author_sort | Patel, Mitesh |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
Beta-agonist overuse is associated with adverse outcomes in asthma, however, the relationships between different metrics of salbutamol use and future risk are uncertain.
Objective
To investigate the relationship between metrics of salbutamol use and adverse outcome.
Methods
In a 24-week randomized controlled trial of 303 asthma patients at risk of severe exacerbations which compared the efficacy and safety of combination budesonide/formoterol inhaler according to a single inhaler regimen (SMART) with a fixed-dose regimen with salbutamol as reliever (‘Standard’), actual medication use was measured by electronic monitoring (Australian New Zealand Clinical Trials Registry Number ACTRN12610000515099). A nested cohort study explored the relationship between metrics of baseline salbutamol use over 2 weeks and future severe asthma exacerbations, poor asthma control (ACQ-5 ≥ 1.5) or ‘extreme’ salbutamol overuse (> 32 salbutamol actuations/24-h period).
Results
Higher mean daily salbutamol use (per two actuations/day) [Odds ratio (OR) (95% CI) 1.24 (1.06–1.46)], higher days of salbutamol use (per 2 days in 2 weeks) [OR 1.15 (1.00–1.31)] and higher maximal 24-h use (per two actuations/day) [OR 1.09 (1.02–1.16)] were associated with future severe exacerbations. Higher mean daily salbutamol use was associated with future poor asthma control [OR 1.13 (1.02–1.26)]. Higher mean daily salbutamol use [OR 2.73 (1.84–4.07)], number of days of use [OR 1.46 (1.24–1.71)], and maximal daily use [OR 1.57 (1.31–1.89)] were associated with an increased risk of future extreme salbutamol overuse.
Conclusion and Clinical Relevance
Electronically recorded frequency of current salbutamol use is a strong predictor of risk of future adverse outcomes in asthma, with average daily use performing the best. These findings provide new information for clinicians considering metrics of salbutamol as predictors of future adverse outcomes in asthma. |
| first_indexed | 2025-11-14T19:50:08Z |
| format | Article |
| id | nottingham-42812 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:50:08Z |
| publishDate | 2013 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-428122020-05-04T20:18:44Z https://eprints.nottingham.ac.uk/42812/ Metrics of salbutamol use as predictors of future adverse outcomes in asthma Patel, Mitesh Pilcher, Janine Reddel, Helen K. Pritchard, Alison Corin, Andrew Helm, Colin Tofield, Christopher Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard Background Beta-agonist overuse is associated with adverse outcomes in asthma, however, the relationships between different metrics of salbutamol use and future risk are uncertain. Objective To investigate the relationship between metrics of salbutamol use and adverse outcome. Methods In a 24-week randomized controlled trial of 303 asthma patients at risk of severe exacerbations which compared the efficacy and safety of combination budesonide/formoterol inhaler according to a single inhaler regimen (SMART) with a fixed-dose regimen with salbutamol as reliever (‘Standard’), actual medication use was measured by electronic monitoring (Australian New Zealand Clinical Trials Registry Number ACTRN12610000515099). A nested cohort study explored the relationship between metrics of baseline salbutamol use over 2 weeks and future severe asthma exacerbations, poor asthma control (ACQ-5 ≥ 1.5) or ‘extreme’ salbutamol overuse (> 32 salbutamol actuations/24-h period). Results Higher mean daily salbutamol use (per two actuations/day) [Odds ratio (OR) (95% CI) 1.24 (1.06–1.46)], higher days of salbutamol use (per 2 days in 2 weeks) [OR 1.15 (1.00–1.31)] and higher maximal 24-h use (per two actuations/day) [OR 1.09 (1.02–1.16)] were associated with future severe exacerbations. Higher mean daily salbutamol use was associated with future poor asthma control [OR 1.13 (1.02–1.26)]. Higher mean daily salbutamol use [OR 2.73 (1.84–4.07)], number of days of use [OR 1.46 (1.24–1.71)], and maximal daily use [OR 1.57 (1.31–1.89)] were associated with an increased risk of future extreme salbutamol overuse. Conclusion and Clinical Relevance Electronically recorded frequency of current salbutamol use is a strong predictor of risk of future adverse outcomes in asthma, with average daily use performing the best. These findings provide new information for clinicians considering metrics of salbutamol as predictors of future adverse outcomes in asthma. Wiley 2013-10 Article PeerReviewed Patel, Mitesh, Pilcher, Janine, Reddel, Helen K., Pritchard, Alison, Corin, Andrew, Helm, Colin, Tofield, Christopher, Shaw, Dominick, Black, Peter, Weatherall, Mark and Beasley, Richard (2013) Metrics of salbutamol use as predictors of future adverse outcomes in asthma. Clinical & Experimental Allergy, 43 (10). pp. 1144-1151. ISSN 1365-2222 beta-agonist budesonide/formoterol control electronic monitoring exacerbations risk http://onlinelibrary.wiley.com/doi/10.1111/cea.12166/full doi:10.1111/cea.12166 doi:10.1111/cea.12166 |
| spellingShingle | beta-agonist budesonide/formoterol control electronic monitoring exacerbations risk Patel, Mitesh Pilcher, Janine Reddel, Helen K. Pritchard, Alison Corin, Andrew Helm, Colin Tofield, Christopher Shaw, Dominick Black, Peter Weatherall, Mark Beasley, Richard Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title | Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title_full | Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title_fullStr | Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title_full_unstemmed | Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title_short | Metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| title_sort | metrics of salbutamol use as predictors of future adverse outcomes in asthma |
| topic | beta-agonist budesonide/formoterol control electronic monitoring exacerbations risk |
| url | https://eprints.nottingham.ac.uk/42812/ https://eprints.nottingham.ac.uk/42812/ https://eprints.nottingham.ac.uk/42812/ |