“Tossing a coin:” defining the excessive use of short-acting beta(2)-agonists in asthma—the views of general practitioners and asthma experts in primary and secondary care

The National Review of Asthma Deaths (NRAD) identified high prescribing of short–acting beta(2)-agonists (SABAs) as a key factor in over 40% of deaths. We interviewed asthma experts from both a hospital background (n = 5) and a primary care background (n = 8), and general practitioners delivering asthma care (n = 8), to identify how SABA use is defined and perceived. We identified disparity in how acceptable SABA use is defined, ranging from 0.5 (100 doses/year) to 12 SABA inhalers (2400 doses/year), and complacency in the perception that over-use did not represent a marker for risk of asthma death. Despite current evidence, these findings suggest clinicians of various backgrounds are complacent about excessive SABA use.