C35-09 SABA Overuse and Urgent Health Care Utilization Among People With Asthma and/or COPD From a Nationally Representative Population

Rationale Over-use of short-acting beta-agonist (SABA) inhalers is associated with increased exacerbations and mortality in asthma, and has also been reported in COPD. Acute exacerbations of obstructive lung diseases can cause significant morbidity and burden on the individual and the health care system. We investigated urgent health care use among Australians with asthma and/or COPD. Methods We conducted a cross-sectional survey of Australian adults (18+ years) randomly selected from a large, web-based survey panel in December 2024. Rigorous methodology was used to minimise response bias and obtain a nationally representative population sample with recruitment stratified by age, sex and state of residence according to national population data. We used a logistic regression model to identify factors associated with urgent health care use in the last 12 months (defined as urgent visit to GP and/or gone to hospital or emergency department and/or spent one or more nights in hospital because of their breathing problem) among people who had ever been diagnosed with asthma and/or COPD and had the condition “at present”. Results Of 10,700 Australian adults surveyed, 1722 had asthma and/or COPD (56.4% female, mean age 47.5 years). Among these, 1092 (63.4%) reported a diagnosis of asthma only, 207 (12.0%) reported both asthma and COPD diagnoses, and 423 (24.6%) reported COPD only. Overall, 808 (46.9%) reported requiring urgent health care for their breathing problem in the last 12 months; 58.5% among those aged <40 years; 45.9% among those aged 40-59 years; and 32.7% among those aged 60+ years. Of 1172 reporting any SABA use in the previous 12 months, 67.8% reported obtaining 3 or more SABA inhalers in that period, and 22.3% reported obtaining 7 or more. Among those using any SABA, factors that increased the risk of requiring urgent health care were younger age, female sex, having a health concession card and over-use of SABA (see Table). People who purchased 7 or more SABA in the last 12 months were 3 times more likely (OR 3.116 (95%CI 2.137-4.544) to require urgent health care than those who purchased 1-2 SABA inhalers. Conclusion Over-use of SABA is common among Australian adults with asthma and/or COPD, and is associated with increased risk of urgent health care utilization.