[Quality prescribing of long-acting beta-agonists. Results of an intervention in Primary Care]

Abstract

Objective: To assess an intervention aimed to reduce inappropriate prescribing of long-acting beta-agonists (LABA) in Primary Care. MATERIAL AND METHODS;

Design: Quasi-experimental pre/post study without control group.

Setting: Aljarafe Primary Health Care Area (Seville, Spain).

Participants: General practitioners with LABA prescriptions without inhaled corticosteroids (iCT), who worked more than 40% of working days in the study period. Study unit: Simple randomised sample of patients with LABA prescriptions without iCT.

Interventions: Mailing educational material with recommendations on the appropriate use of LABA and a list of their patients with inappropriate prescriptions.

Main measurement: Appropriateness of LABA prescriptions as indicated in the Product Summary Characteristics. Patient age, sex, type of LABA and diagnoses were analysed.

Sources: An information system for billing computerized prescriptions and medical history.

Results: Before intervention, prescriptions were inappropriate in 70.3% of patients, and 51.8% received LABA without iCT for unapproved conditions. A diagnosis associated with a respiratory condition was not recorded in the Computerised Medical Records of 18.5% of the patients. After intervention, the percentage of inappropriate prescriptions in the sample dropped to 4.5%, mainly due to a review of the treatment (LABA cessation or iCT addition).

Conclusions: There is a high level of inappropriate use of LABA in Primary Health Care. Mailing educational materials combined with the list of patients with an inappropriate LABA prescription to general practitioners seems to be an effective strategy to improve quality prescribing in respiratory pathologies.