title: Audit of budesonide/formoterol prescribing for asthma in community pharmacy in the U.K.
abstract: The rapid action of the long acting beta agonist formoterol allows it to be used as both a preventer and reliever in the management of asthma. The Symbicort® SMART dosing regime has been shown to reduce the number of asthma exacerbations. The aim was to determine the current prescribing of Symbicort®, the prescribing of the SMART regimen and the co-prescribing of a short acting beta agonist with this regimen by means of an audit of prescriptions dispensed in a pharmacy multiple in the U.K. Anonymised data were collected on a standard form. Symbicort® prescribing data for six months were extracted from the pharmacy Patient Medication Record (PMR). Data were stratified by age and analysed to determine adherence with Symbicort® SMART prescribing as defined by the U.K. product license. Data were received from 51 of the 118 (43.2%) pharmacies contacted. Complete information from 2484 PMRs was included in the study. 2.81% (70/2484) of patients were prescribed SMART as defined by the U.K. summary of product characteristics. Of the 18-35 year age group 7.44% (27/363) were prescribed SMART correctly. However, Symbicort® was prescribed twice a day and when required, with either the co-prescription of a SABA, or at an unlicensed dose in 2.46% (61/2484) and 0.28% (7/2484) patients respectively. The incidence of Symbicort® SMART prescribing in this study is low but may be underestimated due to unclear dosing instructions.
authors.affiliation: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 27 Taylor Street, Glasgow G4 0NR, Scotland, UK. anne.boyter@strath.ac.uk
authors.forename: Anne C
authors.initials: AC
authors.lastname: Boyter
authors.forename: Naomi H
authors.initials: NH
authors.lastname: Ford
authors.forename: Leon
authors.initials: L
authors.lastname: Zlotos
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D019819:Budesonide / Q000191:economics / Q000627:therapeutic use*; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D002648:Child; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000191:economics / Q000379:methods; D004983:Ethanolamines / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data; D008875:Middle Aged; D010594:Pharmacies / Q000706:statistics & numerical data; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004338:Drug Combinations; D004983:Ethanolamines; D019819:Budesonide; D000068759:Formoterol Fumarate