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Over-the-counter use of short-acting beta-2 agonists: a systematic review

BACKGROUND: The widespread use of short-acting beta-2 agonists (SABA) as an as-needed treatment for asthma is well-established. However, excessive use of SABA has been linked to undesirable outcomes such as increased risk of asthma attacks, exacerbations, and even death. The availability of SABA as...

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Autores principales: Loh, Zhe Chi, Hussain, Rabia, Ong, Siew Chin, Saini, Bandana, Muneswarao, Jaya, ur-Rehman, Anees, Babar, Zaheer-Ud-Din
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561505/
https://www.ncbi.nlm.nih.gov/pubmed/37814312
http://dx.doi.org/10.1186/s40545-023-00627-z
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author Loh, Zhe Chi
Hussain, Rabia
Ong, Siew Chin
Saini, Bandana
Muneswarao, Jaya
ur-Rehman, Anees
Babar, Zaheer-Ud-Din
author_facet Loh, Zhe Chi
Hussain, Rabia
Ong, Siew Chin
Saini, Bandana
Muneswarao, Jaya
ur-Rehman, Anees
Babar, Zaheer-Ud-Din
author_sort Loh, Zhe Chi
collection PubMed
description BACKGROUND: The widespread use of short-acting beta-2 agonists (SABA) as an as-needed treatment for asthma is well-established. However, excessive use of SABA has been linked to undesirable outcomes such as increased risk of asthma attacks, exacerbations, and even death. The availability of SABA as an over-the-counter (OTC) medication has contributed to their overuse, leading to undertreated asthma and reduced access to asthma education. OBJECTIVE: This systematic review aimed to summarize the prevalence, characteristic features of, and factors contributing to over-the-counter SABA purchase or overuse. METHODS: The databases searched included PubMed, Scopus, Springer Link, Google Scholar, CINAHL, and APA PsycArticles. Original research articles reporting the prevalence, characteristics features, and factors regarding over-the-counter SABA use, available as full text, published in English language between the year 2000 and April 2023 were included in this review. Commentaries, letters to editor, review articles, qualitative studies, clinical trials, and conference proceedings were excluded. Data extraction was followed by a review of the quality of studies included and data were then synthesized for meaningful findings. This systematic review had been registered in the PROSPERO with registration number CRD42023421007. RESULTS: A total of 18 articles were included. The prevalence range of OTC SABA users in populations were 1.4% to 39.6% and SABA over-users among OTC users were 14% to 66.4%. Factors mostly associated with this behavior were moderate–severe asthma, and less use of preventers. On top of that, not understanding the risk of SABA overuse was clear in many studies that explored this factor. CONCLUSION: Over-the-counter purchase and overuse of SABA medication is a common problem, leading to adverse consequences such as uncontrolled asthma and increased healthcare utilization. Addressing these issues requires improved patient education about their conditions and adequate information regarding the potential long-term effects of SABA use by the healthcare providers. Management and education of asthma patients, including regular monitoring and follow-up, can help reduce overuse of SABA medication and prevent negative consequences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40545-023-00627-z.
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spelling pubmed-105615052023-10-10 Over-the-counter use of short-acting beta-2 agonists: a systematic review Loh, Zhe Chi Hussain, Rabia Ong, Siew Chin Saini, Bandana Muneswarao, Jaya ur-Rehman, Anees Babar, Zaheer-Ud-Din J Pharm Policy Pract Review BACKGROUND: The widespread use of short-acting beta-2 agonists (SABA) as an as-needed treatment for asthma is well-established. However, excessive use of SABA has been linked to undesirable outcomes such as increased risk of asthma attacks, exacerbations, and even death. The availability of SABA as an over-the-counter (OTC) medication has contributed to their overuse, leading to undertreated asthma and reduced access to asthma education. OBJECTIVE: This systematic review aimed to summarize the prevalence, characteristic features of, and factors contributing to over-the-counter SABA purchase or overuse. METHODS: The databases searched included PubMed, Scopus, Springer Link, Google Scholar, CINAHL, and APA PsycArticles. Original research articles reporting the prevalence, characteristics features, and factors regarding over-the-counter SABA use, available as full text, published in English language between the year 2000 and April 2023 were included in this review. Commentaries, letters to editor, review articles, qualitative studies, clinical trials, and conference proceedings were excluded. Data extraction was followed by a review of the quality of studies included and data were then synthesized for meaningful findings. This systematic review had been registered in the PROSPERO with registration number CRD42023421007. RESULTS: A total of 18 articles were included. The prevalence range of OTC SABA users in populations were 1.4% to 39.6% and SABA over-users among OTC users were 14% to 66.4%. Factors mostly associated with this behavior were moderate–severe asthma, and less use of preventers. On top of that, not understanding the risk of SABA overuse was clear in many studies that explored this factor. CONCLUSION: Over-the-counter purchase and overuse of SABA medication is a common problem, leading to adverse consequences such as uncontrolled asthma and increased healthcare utilization. Addressing these issues requires improved patient education about their conditions and adequate information regarding the potential long-term effects of SABA use by the healthcare providers. Management and education of asthma patients, including regular monitoring and follow-up, can help reduce overuse of SABA medication and prevent negative consequences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40545-023-00627-z. BioMed Central 2023-10-09 /pmc/articles/PMC10561505/ /pubmed/37814312 http://dx.doi.org/10.1186/s40545-023-00627-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Loh, Zhe Chi
Hussain, Rabia
Ong, Siew Chin
Saini, Bandana
Muneswarao, Jaya
ur-Rehman, Anees
Babar, Zaheer-Ud-Din
Over-the-counter use of short-acting beta-2 agonists: a systematic review
title Over-the-counter use of short-acting beta-2 agonists: a systematic review
title_full Over-the-counter use of short-acting beta-2 agonists: a systematic review
title_fullStr Over-the-counter use of short-acting beta-2 agonists: a systematic review
title_full_unstemmed Over-the-counter use of short-acting beta-2 agonists: a systematic review
title_short Over-the-counter use of short-acting beta-2 agonists: a systematic review
title_sort over-the-counter use of short-acting beta-2 agonists: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561505/
https://www.ncbi.nlm.nih.gov/pubmed/37814312
http://dx.doi.org/10.1186/s40545-023-00627-z
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