Doctors Overprescribe Inhalers For Acute Asthma by 60%

Pharmacists prompting physicians not to write prescriptions for excessive quantities of inhalers used to treat acute asthma attacks can help reduce over prescription of the inhalers without compromising patient safety while saving money, according to a Medco study released last week. at the annual meeting of the American College of Allergy, Asthma and Immunology. The study shows that when physicians receive educational materials and follow-up communications outreach, and have to give a response before the pharmacist can dispense a prescription, the number of new prescriptions for excessive quantities of rescue inhalers defined as more than one inhaler per month decreased by 60%. The Medco study, conducted between July 2007 and June 2008 on 250,000 patients, found that as a result of the intervention, 200,000 fewer inhalers were used, saving $4.2 million. The researchers also looked at pharmacy and medical claims for a 1,835-patient subset of the study population. During the 12 months following the intervention, 67% of the patients no longer were prescribed excessive quantities of rescue inhalers, while the number of hospitalizations and emergency room visits stayed the same. Rescue inhalers, also known as short-acting beta2 agonists, are meant for patients experiencing acute asthma attacks, though many physicians will prescribe them for daily, long-term use. While wasting medicine, this also can have dangerous implications for patient health by masking exacerbations of the disease and causing more serious problems down the road. “Excessive use of rescue inhalers wastes medicine, but even more importantly, it can be masking an asthma exacerbation,” study researcher Luis Salmun stated. “Rather than over- relying on rescue inhalers, patients should speak to their physicians to make sure that they’re using their daily asthma medications properly or to determine if an adjustment in those medications is needed.”
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