Safer use of short-acting beta ₂ -agonists: perceiving and responding to risk – a qualitative study

BackgroundGlobal asthma guidelines recommend that adults with asthma regularly take inhaled corticosteroids while bronchodilators, such as short-acting beta₂-agonists (SABAs) should only be taken for acute relief when needed. SABA overuse (>1-2 puffs per day) is associated with increased risks of flare ups and deaths. Despite knowing this, many people who have asthma regularly overuse SABAs. This suggests that lower perception of risks of uncontrolled asthma or SABA overuse may drive response to risk. This study aimed to understand why people who have asthma overuse SABAs, and, to explore how they perceive and respond to risks associated with their asthma and their medicines.MethodsPeople with asthma who overuse SABAs were enrolled into the study through community pharmacist invitation. Semi-structured interviews were completed by telephone or via Zoom. The recordings were transcribed and thematically analysed using inductive and deductive approaches.ResultsBetween September 2021 and May 2022, 21 people were interviewed. Data analyses yielded six themes. Three themes related to risk perception including risks related to asthma, medicines, and other factors such as environmental triggers. Three themes related to how people responded to their perceived risk. These included actions taken by some to reduce risk while others chose not to act to reduce risk, despite knowing how to, suggesting a lack of self-efficacy.ConclusionsThis is the first study of its kind in a group of Australians who have asthma, a common, as yet incurable, often lifelong chronic health condition. Our interviews yielded rich and sometimes surprising insights into the complexity and number of factors contributing to how people perceive and respond to risks associated with their asthma and with the medicines that they take to manage it.