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Using a short-acting Beta2 agonist (SABA) inhaler 3 or more times a week is an indicator that asthma is not well controlled, which in turn could mean an increased risk of asthma attacks.1–3
Experts have co-developed a 5-item questionnaire to assess reliance on SABA inhalers. Click below to view the Reliever Reliance Test.
EVIDENCE REVEALS THE GLOBAL PUBLIC HEALTH BURDEN OF SABA OVER-RELIANCE
Over-reliance on SABA inhalers (usually a blue inhaler) is common among people with asthma.4 Many patients feel ‘attached’ to their SABA inhaler, believing this to be the best way to control their symptoms.5
Studies have shown that 90% of asthma patients want fast relief from their symptoms.6 Most patients don’t understand that the SABA inhaler they use when they feel symptomatic doesn’t address the underlying cause of their asthma.7,8
Although SABA inhalers provide quick relief of symptoms, over-reliance (e.g. when patients use their SABA inhaler 3 or more times a week) is an indicator that asthma is not well controlled, which in turn is associated with an increased risk of exacerbations.1–4 If patients are prescribed 3 or more SABA canisters a year, that might also indicate that asthma is not well controlled, which is associated with an increased risk of asthma attacks and, in some cases, even premature death.1,2,8
Currently, observational studies are underway around the world to evaluate the burden of SABA overuse in asthma and the resultant negative impact on asthma-related clinical outcomes.
Learn more from Dr. Alan Kaplan on the issue of SABA over-reliance and the unnecessary risks posed to asthma patients.
In light of the COVID-19 global pandemic and at a time when health systems are overstretched, helping patients to effectively self-manage their asthma and reduce their risk of exacerbation so that they stay out of hospital is now more important than ever before.9 In addition, medical experts agree that for people with asthma, the best way of staying healthy and recovering if infected with COVID-19, is to ensure their asthma is as stable as possible.9
Implementing new clinical approaches and changing behaviour to tackle SABA over-reliance can be a challenge. Evidence shows that discussions between HCPs and patients to support changes in asthma self-management may be more effective if they take into account the patients’ underlying expectations and concerns.10
Adapted from the validated SABA Risk Questionnaire,5 the Reliever Reliance Test is a patient-friendly digital tool designed to identify whether a patient might be over-reliant on their SABA inhaler. Read more about the research behind the tool.
Watch the video to understand the impact of SABA over-reliance on patients and their families, and how an improved health system designed to better manage asthma could make a difference.
The Reliever Reliance Test is adapted from the validated and globally used Beliefs about Medicines Questionnaire11 and has been developed by leading expert in behavioural medicine, Professor Rob Horne, with colleagues from the International Primary Care Respiratory Group (IPCRG). It was fully funded by AstraZeneca UK Limited. The Asthma Right Care initiative is a global movement led by the IPCRG funded by AstraZeneca globally.
This is not medical advice DO NOT stop or change your asthma medication without consulting your healthcare professional. It is important to continue to take your Blue Reliever Inhaler as directed by your healthcare professional, including during any worsening of your asthma or prior to exercise.
IPCRG VERSION 2.0
1. Global Initiative for Asthma. (GINA). Available at: https://ginasthma.org/wp-content/uploads/2020/04/Main-pocket-guide_2020_04_03-final-wms.pdf (Last accessed: October 2020).
2. Price D, et al. NPJ Prim Care Respir Med. 2014:12;24:14009<
3. Azzi EA, et al. BMJ Open. 2019:14;9(8):e028995.
4. Cole S, et al. BMJ Open. 2013;3(2):e002247
5. Chan AHY, et al. J Allergy Clin Immunol. 2020:20;S2213–2198(20)30722–4
6. Partridge, MR et al. BMC Pulm Med. 2006;6:13
7. Humbert M, et al. Allergy. 2008;63(12):1567–80
8. Nwaru BI, et al. Eur Respir J. 2020 Apr 16;55(4):1901872
9. CEBM. Asthma and COVID-19: risks and management considerations. Available at: https://www.cebm.net/covid-19/asthma-and-covid-19-risks-and-management-considerations/ (Last accessed: October 2020)
10. Pinnock H, et al. Breathe (Sheff). 2015 Jun;11(2):98–109
11. Horne R, et al. Psychology & Health. 1999;14(1):1–24
This website is an international information resource for people with an interest in SABA/blue reliever inhaler over-reliance in asthma.