Background:Inappropriate utilization of asthma medications is a serious global concern, with overuse of short-acting beta2-agonists (SABA) leading to uncontrolled asthma and increased risk of exacerbations and related hospitalizations. 

Aim: To understand the pattern and extent of SABA inhaler overuse and its impact on clinical outcomes among asthma patients in India.

Methods: Physician-diagnosed asthma patients were recruited randomly via telephone from 15 centers across India. They were administered an online questionnaire that captured their extent and usage pattern of SABA inhalers, their level of asthma control, number of asthma exacerbations and related hospitalizations.

Results: 630 asthma patients aged 18-50 years responded to the survey. Among these, 241 (38%) asthmatics reported using a SABA inhaler [214 (34%) as SABA monotherapy and 27 (4%) along with controller inhalers]. Among the patients using SABA inhalers, 58% used them on a regular/daily basis and 74% used ?3 canisters/year (29% 3-5 canisters, 40% between 6-10 canisters and 5% ?11 canisters). As compared to those who used <3 SABA canisters/year, overuse of SABA (3 or more canisters per year) was associated with significant increase in uncontrolled asthma (50% Vs 34%, p<0.05) and asthma-related hospitalizations (24% Vs 8%, p<0.01).

Conclusion: More than 1/3rd of asthma patients in India use SABA inhaler as monotherapy, with a substantial proportion using them daily. Overuse of SABA inhalers was associated with uncontrolled asthma and hospitalizations.