What type of study is this?

This is a Interrupted Time Series Analysis study.

September 10, 2025

Impact of regional asthma guidelines on SABA prescribing patterns across England: an interrupted time series analysis

Key Points

Publication of AIR guidelines led to a reduction in SABA prescribing by 0.26% per month, indicating effective guidelines.
SABA-first guidelines showed a smaller decline of 0.1% per month, with AIR guidelines significantly outperforming them.
Analysis categorized 34 regional guidelines into three types, highlighting how they influence prescribing behavior.
Aligning local practices with national recommendations could enhance patient outcomes for asthma management.

Abstract

The 2024 British Thoracic Society/ National Institute for Health and Care Excellence/ Scottish Intercollegiate Guidelines Network asthma guidelines recommend anti-inflammatory reliever (AIR)-based management, providing opportunity to reduce short-acting beta agonist (SABA) over-use. Many English regions also publish local guidelines. Analysis of 34 regional guidelines enabled grouping into three categories: SABA-first, inhaled corticosteroid (ICS) plus SABA and AIR (as-needed AIR), based on recommended initial treatment. Interrupted time series analysis using publicly available data demonstrated that AIR guideline publication resulted in the greatest decline in SABA prescribing, expressed as the proportion of all ICS-containing and SABA inhaler prescriptions (AIR: −0.26% (SD 0.09%) per month; SABA-first: −0.1% (SD 0.03%) per month, p=0.001 vs AIR; and ICS plus SABA: −0.16% (SD 0.06%) per month, p=0.004, vs AIR). Therefore, regional guidelines do affect local prescribing practice and alignment with the latest national recommendations could improve asthma prescribing and resulting patient outcomes.

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