Real-Life Patterns of Short-Acting Beta-Agonist Use in Persistent Asthmatics Vary by Age, Time of Day, and Season

RATIONALE: Seasonal and diurnal patterns of asthma symptoms have been demonstrated. We utilized objective data obtained from electronic inhaler sensors to monitor patterns of short-acting beta-agonist (SABA) use in a large real-world population.

METHODS: Persistent asthmatics requiring controller therapy had a sensor attached to their SABA and access to the Propeller Health digital platform. Data were categorized by age group. Tests for the difference between two Poisson rates compared average monthly rescue medication use between months and average hourly medication use between times of day.

RESULTS: Analysis of hourly SABA use included 1738 patients with 60,700 patient/weeks of data. SABA use peaked at 7AM in all age groups (0.023 average puffs/person-hour; 95% CI 0.022 to 0.023), with a midday trough and a late evening return to increased use. Midday SABA use declined by 65% and 29% in children ≤11 years and adults ≥18 years, respectively. Analysis of monthly SABA use included between 768 and 1042 patients per month. Overall, peak SABA use occurred in May (0.41 average puffs/person-day; 95% CI 0.40 to 0.42). In children ≤11 years, expected daily SABA use peaked in March and declined to 57% of peak by July. In adults ≥18 years, SABA use peaked in May, with a decline to 35% of peak by October.

CONCLUSIONS: Objective patterns of SABA use vary by age, time of day, and season in patients with persistent asthma. Such insights should play a pivotal role when developing personalized strategies to prevent these temporal increases in symptoms.