This measure details the percentage of PHO-enrolled population aged 5-44 years who are dispensed a short-acting beta-agonist (SABA) in at least two quarters in a year and were not dispensed preventer in two or more quarters in the same year.
High rates of people not receiving regular preventer therapy despite regular SABA use demonstrates non –adherence to best practice guidelines and suboptimal disease management.
The ARFNZ Adolescent and Adult Asthma guidelines (2020) defines good control of asthma as requiring a SABA reliever on ≤2 days per week.
The guideline recommends that ICS or ICS/LABA therapy is introduced if patients have symptoms consistent with a diagnosis of asthma.
This indicator replaces the previous indicator of reliever: preventer ratio.
Numerator detail
SABA (relievers): beta-adrenoceptor agonists 209606, 209609, 209611, 209612, 209613, 209614, 209615, 209616, 209617 Salbutamol; 240406, 240407, 240408, 240409, 240410, 240425 Terbutaline Sulphate
Preventers:
Inhaled corticosteroids: 110801,110802, 110803, 110804, 110805, 110806, 110807, 110808, 110809, 110815, 110816, 110825, 110826 & 110827 Beclomethasone dipropionate;
116801, 116802, 116803, 116804 & 116805 Budesonide;
106501, 106502, 106503, 106504, 106505, 106506, 106507, 106508, 106509, 106510, 106511, 106512, 106513, 106514 & 106525 Fluticasone
Inhaled long-acting beta-adrenoceptor agonists: 106601, 106602, 106603 & 106625 Salmeterol; 108301, 108302 & 108303 Eformoterol fumarate; 411225 Eformoterol fumarate dihydrate;
404225 & 404226 Indacaterol;
Inhaled corticosteroids with long-acting beta-adrenoceptor agonists: 375825, 375826, 375827, 375828, 375829, 375830 & 375831 Budesonide with eformoterol;
385825, 385826, 385827 & 385828 Fluticasone with salmeterol;
405625 Fluticasone furoate with vilanterol
PHO-enrolled population aged 5-44 years who dispensed SABA in two or more quarters in a year.
Denominator detail
SABA (relievers): beta-adrenoceptor agonists 209606, 209609, 209611, 209612, 209613, 209614, 209615, 209616, 209617 Salbutamol; 240406, 240407, 240408, 240409, 240410, 240425 Terbutaline Sulphate
Disaggregation
District analysis: By year (2018 –2023), age group (5 –11, 12 –24, 25 44), gender (female, male), ethnic group (Māori, Pacific peoples, European/Other), and Health New Zealand district of domicile.
PHO analysis: By year (2023), age group, gender, Primary Health Organisation (PHO) most recently enrolled with (for the relevant year), PHO group (small, medium, medium-large and large).
People who were excluded from analysis include:
- those who aren’t enrolled in a PHO in the calendar year. This allowed us to use the number of PHO-enrolled people as the denominator.
- individuals with missing demographics – that is, those with no recorded value for one or more of the NHI fields used to derive the demographic variables of interest (age, gender, ethnicity and district of domicile). For instance, if there are any missing values for age, they are excluded from all analyses. This approach ensures a consistent denominator throughout the analyses.
Age group is assigned using 30 June of each calendar year as the cutoff point. For example, if a person turned 45 years old on 1 July 2023, they will still be considered 44 years old for 2023.
People who died during the calendar year were excluded from the analyses of this indicator.
Data is not presented where the number of people in the numerator was less than 10. This is to preserve confidentiality.
In contrast to other atlases, and following advice, we defined regular dispensing as the medication dispensed in two or more quarters of the calendar year. The reason for this difference is that some inhalers can last for more than three months.