How many short-acting reliever inhalers a patient uses is one of the simplest markers of asthma control and risk. Using three or more canisters a year is associated with more exacerbations, and very high use with asthma deaths.
Ask how many relievers were bought in the last year, or check the pharmacy record. A patient getting through a reliever every month or two is poorly controlled, whatever they say about their symptoms, and needs their treatment reviewed rather than another prescription.
- Ask how many reliever inhalers were used in the past year.
- Treat three or more canisters a year as a sign of poor control.
- Review technique, adherence and controller therapy when reliever use is high.
- Do not repeat reliever prescriptions without a review.
Why it matters
Reliever overuse is the warning sign most often hidden in plain sight on a repeat prescription.
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