Research Roundup

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Debbie Rigby rounds up the latest in research news

Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists

An Australian community pharmacy-based survey highlights the overuse of asthma reliever inhalers (SABAs) from community pharmacies. The survey of 412 participants that over 70% were overusers, defined as use more than twice a week within the last 4 weeks. Nearly three-quarters of participants reports not using a preventer daily. This study uncovers a hidden population of people who can only be identified in pharmacy with suboptimal asthma, coexisting rhinitis, poor preventer adherence and, in some cases, no asthma diagnosis.

BMJ Open 2019;9:e028995.


Aspirin for the Primary Prevention of Cardiovascular Diseases in the Context of Contemporary Preventive Strategies

A meta-analysis of 14 recent randomised clinical trials involving 164,751 patients shows aspirin is not associated with a decreased risk of myocardial infarction and demonstrates an increased risk of major bleeding and haemorrhagic stroke. The authors conclude routine use of aspirin for the primary prevention of cardiovascular events may have a net harmful effect.

American Journal of Medicine, available online 31 May 2019.


Beta‐blocker use is an independent risk factor for thunderstorm asthma

An Australian retrospective case-control study has concluded that oral beta‐blocker medications, younger age and Asian‐born heritage are independent risk factors for thunderstorm asthma. Non‐steroidal anti‐inflammatory drugs and aspirin are not risk factors for thunderstorm asthma. No difference was found for allergies to medication, grass pollen and animals. Oral beta-blockers increased the risk of thunderstorm asthma more than 6-fold.

Emergency Medicine Australasia, first published 18 March 2019.


Undiagnosing to prevent overprescribing

Diagnoses need to be reviewed periodically as, with time, it may appear that the condition has ameliorated or represents normal ageing rather than pathology. A sophisticated medication review process is to challenge and remove diagnoses that are no longer relevant, with consideration of the associated medications. Removing diagnoses means that medications can correspondingly be withdrawn, leading to reduced prescribing.

Maturitas 2019;123:67-72.

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