University of Alberta researchers raise concern on asthma
University of Alberta researchers have uncovered a worrying trend in the dispensation of asthma medications that if addressed could improve patient outcomes and reduce hospital visits.
In research published online, the team looked back at dispensation records for the 10 most commonly prescribed asthma medications in Alberta over a 12-year period from 2009 to 2020, and cross-referenced them with administrative data on doctor and hospital visits for 4.5 million Albertans.
They found that while asthma prevalence increased by about 50 per cent, the number of prescriptions filled was low and remained stable, and the dispensation trend for pediatric patients actually decreased.
“I tell you, our eyes jumped out of our heads when we saw the numbers,” says pulmonary specialist Mohit Bhutani, professor in the Faculty of Medicine & Dentistry and president-elect of the Canadian Thoracic Society. “This is a bigger problem than we realized.
“On average, the number of dispensations was at or below one three-month prescription per year. So basically for three-quarters of the year, you don’t have enough medications to cover chronic management.”
Bhutani says many patients may not realize they can achieve a normal quality of life if they use their inhaled therapies optimally.
Asthma is a chronic inflammatory lung disease that makes it difficult to breathe, affecting 3.8 million Canadians and between seven and 12 per cent of Albertans, according to Statistics Canada. It’s more common in males than females, and in children rather than adults. There can be a range of severity, but on average people with asthma have more sick days from school or work and more interactions with the health-care system.
In the study, the researchers report there were an average of 21,000 emergency department admissions for acute asthma in Alberta each year between 2014 and 2018. Canadian Thoracic Society treatment guidelines recommend that everyone with an asthma diagnosis should use maintenance medication on a daily basis if they experience more than two symptoms in a week, including shortness of breath at rest or with exercise, wheezing, chest tightness or coughing.
“If you don’t use your medication regularly, you’re likely to have more of those symptoms, and the less control you have, the more likely you are to have a flare-up that would require an unexpected visit to your family physician or an emergency department visit or a hospitalization,” Bhutani says.
Some people, especially parents of children with asthma, may be wary of giving inhaled corticosteroids on a regular basis, but Bhutani says these drugs are “the quarterback or cornerstone therapy” for managing the disease. He adds that asthma is a very treatable disease and for most asthmatics, they can have a normal quality of life if treatments are implemented.