Asthma management and mode of acquisition of inhaled bronchodilators

Controversy has existed about the benefits and disadvantages associated with the availability of inhaled bronchodilators over the counter (OTC).

To compare sociodemographic features, use of preventive medications, use of medical services and control of asthma in adults who purchased inhaled bronchodilators OTC with those who purchased on prescription (script).

A cross-sectional telephone survey of 772 adults 18 years and over who used inhaled bronchodilators for their asthma. Symptoms, asthma medications, and management practices were determined by a structured questionnaire administered by trained telephone interviewers.

Two hundred and thirty adults purchased their bronchodilator OTC and 542 on script. OTC purchasers were more likely to be male (OR: 1.5), have had tertiary education (1.5) and be in paid employment (2.8); they were less likely to report frequent symptoms (wheeze, nocturnal symptoms or EIA more than once a week) (0.71); were less likely to use preventive medications more than twice a day (0.57) and were less likely to have consulted a general practitioner in the previous year (0.38). However, poor control of asthma symptoms was evident in both OTC and script groups. Forty per cent of the OTC group who had symptoms more than two to three times a week and 34% of the script group were not using preventive medication.

Undertreatment and suboptimal management of asthma were apparent in both OTC and script groups.