{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:40:17Z","timestamp":1761864017580,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["PD\/BD\/113665\/2015"],"award-info":[{"award-number":["PD\/BD\/113665\/2015"]}]},{"name":"COMPETE 2020 and Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["POCI-01-0145-FEDER-029130"],"award-info":[{"award-number":["POCI-01-0145-FEDER-029130"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Allergy"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Recurrent use of oral corticosteroids (OCS) and over-use of short-acting beta-2-agonists (SABA) are factors associated with adverse side effects and asthma-related death. We aim to quantify high OCS exposure, SABA over-use and its association with prescription and adherence to maintenance treatment for respiratory disease, among patients with prescriptions for respiratory disease, from the Portuguese electronic prescription and dispensing database (BDNP).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a 1-year (2016) retrospective population-based analysis of a random sample of adult patients from the BDNP, the nationwide compulsory medication prescription system. We assessed high OCS exposure (dispensing\u2009\u2265\u20094 packages containing 20 doses of 20\u00a0mg each of prednisolone-equivalent, \u2265\u20091600\u00a0mg\/year) on patients on persistent respiratory treatment (PRT-prescription for &gt;\u20092 packages of any respiratory maintenance medications). Excessive use of SABA was defined as having a ratio of SABA-to-maintenance treatment &gt;\u20091 or having SABA over-use (dispensing of &gt;\u20091\u2009\u00d7\u2009200 dose canister\/month, of 100\u00a0\u03bcg of salbutamol-equivalent). Factors associated with high OCS exposure were assessed by multinomial logistic regression.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The estimated number of patients on PRT was 4786\/100,000 patients. OCS was prescribed to more than 1\/5 of the patients on PRT and 101\/100,000 were exposed to a high-dose (\u2265\u20091600\u00a0mg\/year). SABA excessive use was found in 144\/100,000 patients and SABA over-use in 24\/100,000. About 1\/6 of SABA over-users were not prescribed any controller medication and 7% of them had a ratio maintenance-to-total \u2265\u200970% (high prescription of maintenance treatment). Primary adherence (median%) to controller medication was 66.7% for PRT patients, 59.6% for patients exposed to high OCS dose and 75.0% for SABA over-users. High OCS exposure or SABA over-use were not associated with primary adherence. High OCS exposure was associated with a maintenance-to-total medication ratio &lt;\u200970% (insufficient prescription of maintenance treatment), age &gt;\u200945\u00a0years old and male sex.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Exposure to high-dose of OCS (101 per 100,000 patients) and SABA over-use (24 per 100,000) were frequent, and were associated with a low maintenance-to-total prescription ratio but not with primary non-adherence. These results suggest there is a need for initiatives to reduce OCS and SABA inappropriate prescribing.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13601-019-0286-3","type":"journal-article","created":{"date-parts":[[2019,9,22]],"date-time":"2019-09-22T23:02:56Z","timestamp":1569193376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["High oral corticosteroid exposure and overuse of short-acting beta-2-agonists were associated with insufficient prescribing of controller medication: a nationwide electronic prescribing and dispensing database analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9429-6863","authenticated-orcid":false,"given":"Ana","family":"S\u00e1-Sousa","sequence":"first","affiliation":[]},{"given":"Rute","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Ricardo","family":"Vicente","sequence":"additional","affiliation":[]},{"given":"Nilton","family":"Nascimento","sequence":"additional","affiliation":[]},{"given":"Henrique","family":"Martins","sequence":"additional","affiliation":[]},{"given":"Alberto","family":"Freitas","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o Almeida","family":"Fonseca","sequence":"additional","affiliation":[]}],"member":"311","published-online":{"date-parts":[[2019,9,23]]},"reference":[{"issue":"9","key":"286_CR1","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/S2213-2600(17)30293-X","volume":"5","author":"GBD 2015 Chronic Respiratory Disease Collaborators","year":"2017","unstructured":"GBD 2015 Chronic Respiratory Disease Collaborators. 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Data had previously been anonymised.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JAF received personal fees outside the submitted work from AstraZeneca, GSK, Mundipharma, Novartis, Teva. All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"47"}}