Short acting beta agonist inhalers

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Number of short acting beta agonist (SABA) inhalers - salbutamol and terbutaline - compared with number of all inhaled corticosteroid inhalers and SABA inhalers
Why it matters The BTS/NICE/SIGN guidance has updated guidance on use of short acting beta agonists (SABAs), and states do not prescribe short-acting beta2 agonists to people of any age with asthma without a concomitant prescription of an ICS. In addition, it also recommends that patients aged 12 and over with uncontrolled asthma (e.g. needing a reliever 3 or more days a week) should have their treatment changed to a non SABA-based regimen.

Why Asthma Still Kills reports that high use of SABAs (salbutamol and terbutaline) and poor adherence to inhaled corticosteroids in asthma suggests poor control - these patients should be reviewed regularly to ensure good control.

The NHS England National Medicines Optimisation Opportunities for 2024/25 identify improving patient outcomes from the use of inhalers as an area for improvement.
Tags Standard, Respiratory, National medicines optimisation opportunities, Safety
Implies cost savings No
Authored by richard.croker
Checked by christopher.wood
Last reviewed 2024-12-02
Next review due 2025-12-02
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(p.quantity/adj.qtyadj) AS numerator
 FROM hscic.normalised_prescribing p  INNER JOIN measures.vw__inhaler_quantity_adjustment as adj ON p.bnf_code = adj.bnf_code AND p.month = adj.date -- joins prescribing data to view for form_route and adjustment where quantity = puffs not inhalers
 WHERE adj.form_route IN ('pressurizedinhalation.inhalation', 'powderinhalation.inhalation', 'inhalationsolution.inhalation') AND ( 
 p.bnf_code LIKE '0301011R0%' -- Salbutamol 
 OR p.bnf_code LIKE '0301011V0%') -- Terbutaline
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(p.quantity/adj.qtyadj) AS denominator
 FROM hscic.normalised_prescribing p  INNER JOIN measures.vw__inhaler_quantity_adjustment as adj ON p.bnf_code = adj.bnf_code AND p.month = adj.date -- joins prescribing data to view for form_route and adjustment where quantity = puffs not inhalers
 WHERE adj.form_route IN ('pressurizedinhalation.inhalation', 'powderinhalation.inhalation', 'inhalationsolution.inhalation') AND ( 
 p.bnf_code LIKE '0301011R0%' -- Salbutamol 
 OR p.bnf_code LIKE '0301011V0%' -- Terbutaline 
 OR p.bnf_code LIKE '0302%') -- Corticosteroids (Respiratory)
 GROUP BY month, practice_id
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