Switching asthma patients to cheaper inhaler harms control
By Nigel Praities
Switching patients onto cheaper asthma inhalers can have serious consequences on the control of their disease, say UK researchers.
In the first study to follow the outcome of patients who have their asthma inhaler switched without a consultation, the researchers found the switch was unsuccessful in over half after a year.
The study challenges increasing pressure from PCTs for practices to change patients onto cheaper inhalers, as the majority of patients were switched from dry powder inhalers to cheaper metered-dose inhalers.
The study collated information from 800 patient records on the General Practice Research Database and found asthma patients switched without a consultation or a visit had less than one third the chance of successful treatment after one year.
Of the switched patients, 51% experienced unsuccessful treatment – based in a composite score of short-acting beta-agonist, oral steroid and controller therapy use and hospitalisation – compared with 38% of matched controls.
The authors said while there was increasing pressure for GPs to switch patients with asthma to cheaper inhaler devices, this was not advisable in all cases and should not be done without making sure the patient is comfortable and able to use the device.
‘The possible costs of adverse effects on asthma control should be weighed against savings in acquisition costs before instituting mass switching of ICS inhaler devices. Switching ICS inhaler devices without a face-to-face evaluation and consultation is inadvisable,' they said.
The study was published this month in BMC Pulmonary Medicine.Switching asthma patients to cheaper inhalers can harm control Switching asthma patients to cheaper inhalers can harm control