There is an association between greater short-acting beta-agonist (SABA) use and lower adherence with higher burden chronic obstructive pulmonary disease (COPD) assessment test (CAT) scores in patients with COPD, according to study results published in the journal Respiratory Medicine.

CAT scores were used to group patients with COPD older than 40 years into either high or low COPD burden groups. Associations between groups were compared to find correlations between COPD burden and other risk factors. Electronic medication monitors were used to capture use of SABAs that may indicate disease worsening in real time.

Among the 2196 patients with COPD, 649 used rescue and maintenance medication, 203 used maintenance-only medications, and 1344 used rescue-only medications. CAT scores from low to very high burden categories were associated with increasing SABA use from 0.8 to 1.9 average puffs per day (+1.1; 95% CI, 0.6-1.6 puffs/d; P <.001). In addition, lower CAT scores were associated with higher maintenance medication adherence.

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“The association of higher CAT scores and increasing SABA use suggests the potential value of SABA data as a surrogate for CAT,” the researchers wrote. “This information can help identify patients to have a discussion with their provider to address barriers to adherence and possible therapy alterations to reduce exacerbation risk.”

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Gondalia R, Bender BG, Theye B, Stempel DA. Higher short-acting beta-agonist use is associated with greater COPD burden. Respir Med. 2019;158:110-113.