Excess SABA Prescribing in Respiratory Patients and Social Deprivation in General Practice: A Study of 4 Million Patients

OBJECTIVES: The Index of Multiple Deprivation (IMD) is a more comprehensive measure of socioeconomic status than income, and to date its association with respiratory outcomes has been largely unexplored. We determined if respiratory patients in GP practices with lower IMD score might be at greater risk of receiving an increased number of short-acting b2-agonists (SABA) prescriptions, indicating worse disease control, therefore less good treatment/management.

METHODS: Within a historical, cohort study design in the UK OPCRD population, we obtained prescribing data for all patients who received a SABA between 2004 and 2022 (inclusive) in the UK OPCRD dataset. We correlated the number of patient event/years with each IMD score decile taken from the GP practice to which the patient was registered. We endorsed STROBE guidance for observational research.

RESULTS: From a total of 25,341,845 patients in OPCRD, 4,090,380 fulfilling all inclusion and exclusion criteria were studied. Respiratory patients in lower scoring IMD practices (more deprived) received significantly more SABA prescriptions per year (r2=0.8943, p<0.001, Figure). A similar trend was observed when looking at the proportion of patients receiving 3 or more SABA prescriptions in any given year.

CONCLUSIONS: Respiratory patients belonging to more deprived GP practices tend to use relief medication more frequently, suggesting that they are inherently less well controlled.