Reducing SABA over-reliance in NHS Lothian through prescribing data (ID 297)
University of Edinburgh
Funding: None
Abstract
BackgroundOver-reliance of short-acting beta-agonists (SABA) often indicates poor asthma control and is a predictor for future risk of asthma attack and death. The Scottish Therapeutics Utility (STU) tool uses data from GP health records to provide practice-level reports on repeat and high-risk prescribing. STU contains five searches relating to respiratory, including >12 SABA in 1 year, without a diagnosis of COPD’. STU is installed across Lothian, yet not every practice used it. We aimed to improve primary care prescribing of SABA in NHS Lothian, Scotland, by improving awareness of STU data.
Methods
A training event raised awareness of STU and the ease at which high risk asthmatic patients could be identified. Practices were incentivised to analyse their data and review patients’ over-ordering SABA’s. We analysed SABA prescribing data extracted from STU before (June 2019) and after the intervention (May 2021).
Results
Before the intervention, >12 SABA were prescribed to an average of 56 patients per practice (standard deviation (SD) 71). There was wide variation in prescribing: per practice, the minimum number of individuals receiving >12 SABA was 10; the highest was 602 patients. Following the intervention, the number of individuals receiving >12 SABA decreased with an average of 36 per practice and a reduction in variation between practices (SD 28).
Lessons learned
Although STU data was available prior to the intervention, few practices were aware of the benefits. Following the intervention, a reduction in the number of individuals who were prescribed >12 SABA per year which was seen across all areas of the health board.
Messages for others
We saw a reduction in SABA over-prescribing in NHS Lothian by promoting the use of primary care data to help educate and encourage practices to change prescribing. To see change, we needed to raise awareness directly with users.
Conflicts of interest: None
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