OBJECTIVES: SABA and OCS are used for the management of acute COPD and asthma symptoms. Higher SABA use is associated with increased mortality risk and even short OCS courses are associated with increased risk of adverse events and additional costs of prescription drugs to manage these comorbidities. This study aims to understand variations in SABA and OCS use in patients with asthma and COPD at an Integrated Care Board (ICB) level.

METHODS: A relational model was created in Microsoft PowerBI using the following data sources:

National Health Service Business Services Authority Respiratory Dashboard (NHSBSARD) Prednisolone (OCS) use: the number of unique patients prescribed prednisolone during 12 months.

NHSBSARD High SABA use: six or more prescriptions for SABA inhalers per year.

Quality and Outcomes Framework (QoF): OCS use data was normalized to the total number of COPD and asthma patients registered in primary care in England.

ICB Geography: NHSBSARD data is presented at Sub-ICB-Location level, a mapping exercise was performed to wrap the data up to ICB level and develop heat maps.

RESULTS: High SABA usage amongst respiratory patients in England in 2022 varied significantly ranging from 16.0% of respiratory patients in Gloucestershire ICB using more than six SABA inhalers a year to 31.3% in Cheshire & Merseyside ICB. For the same year usage of a cumulative prednisolone dose of 1000mg or more (≥five courses a year) varied from 1.5% in North/Central London ICB to 4.4% in Shropshire, Telford and Wrekin ICB.

CONCLUSIONS: Even though the data on SABA and OCS use is not presented at a granular level in the NHSBSARD for asthma and COPD separately, there are geographical variations in the management of respiratory patients in England. It is important to minimize these variations to not only address high healthcare costs but also minimize inequalities in health outcomes.