Experiences and behaviours of patients with asthma requesting prescriptions from primary care during medication shortages linked to the COVID-19-lockdown: insights from a qualitative analysis of a UK asthma online community

Background Inhaler shortages were reported in the UK following declaration of the COVID-19 pandemic, prompting advice against stockpiling.

Aim To understand experiences and behaviours of patients with asthma requesting prescriptions from primary care during asthma medication shortages.

Design & Settings UK asthma online community, between March and December 2020.

Method Thematic analysis of posts identified using search terms ‘shortage’, ‘out of stock’, ‘prescribe’ and ‘prescription’.

Results 66 participants were identified (46 adults, 2 parents of children with asthma, 18 unstated). Factors leading to increased requests included: stockpiling, early ordering, realising inhalers were out-of-date, and doctors prescribing multiple medication items. Patients’ anxieties that could lead to stockpiling included fear of asthma attacks leading to admission and acquiring COVID-19 in hospital, lack of dose counters on some inhalers, and believing a lower amount of drug is delivered in the last actuations. Strategies adopted in relation to shortages or changes in treatment due to out-of-stock medications included starting stockpiling, ordering prescriptions early, contacting medical professionals for advice or alternative prescriptions, getting ‘emergency prescriptions’, ordering online or privately, seeking medications in different pharmacies, contacting drug manufacturers and keeping track of number of doses left in canisters. We found no evidence of anxiety-triggered asthma symptoms that required medications due to fear of COVID-19. Participants seemed to disregard advice against stock-piling.

Conclusions Better preparation is a key lesson from COVID-19. Clinicians, the pharmaceutical industry, and policy makers should use insights from this work to plan how to better manage medication shortages in future emergency situations.