Audit of budesonide/formoterol prescribing for asthma in community pharmacy in the U.K.

The rapid action of the long acting beta agonist formoterol allows it to be used as both a preventer and reliever in the management of asthma. The Symbicort® SMART dosing regime has been shown to reduce the number of asthma exacerbations. The aim was to determine the current prescribing of Symbicort®, the prescribing of the SMART regimen and the co-prescribing of a short acting beta agonist with this regimen by means of an audit of prescriptions dispensed in a pharmacy multiple in the U.K. Anonymised data were collected on a standard form. Symbicort® prescribing data for six months were extracted from the pharmacy Patient Medication Record (PMR). Data were stratified by age and analysed to determine adherence with Symbicort® SMART prescribing as defined by the U.K. product license. Data were received from 51 of the 118 (43.2%) pharmacies contacted. Complete information from 2484 PMRs was included in the study. 2.81% (70/2484) of patients were prescribed SMART as defined by the U.K. summary of product characteristics. Of the 18-35 year age group 7.44% (27/363) were prescribed SMART correctly. However, Symbicort® was prescribed twice a day and when required, with either the co-prescription of a SABA, or at an unlicensed dose in 2.46% (61/2484) and 0.28% (7/2484) patients respectively. The incidence of Symbicort® SMART prescribing in this study is low but may be underestimated due to unclear dosing instructions.