Abstract
Background: To gain a global perspective on short-acting β2-agonist (SABA) prescriptions and associated asthma-related clinical outcomes in patients with asthma, we assessed primary health data across 24 countries in 5 continents.
Methods: SABINA III was a cross-sectional study that employed electronic case report forms at a study visit (in primary or specialist care) to record prescribed medication(s), over-the-counter (OTC) SABA purchase, and clinical outcomes in asthma patients (≥12 years old) during the past 12 months. In patients with ≥1 SABA prescription, associations of SABA with asthma symptom control and severe exacerbations were analysed using multivariable regression models.
Results: Of 8351 patients recruited (n=6872, specialists; n=1440, primary care), 76.5% had moderate-to-severe asthma and 45.4% experienced ≥1 severe exacerbation in the past 12 months. Thirty-eight percent of patients were prescribed ≥3 SABA canisters; 18.0% purchased OTC SABA, of whom 76.8% also received SABA prescriptions. Prescriptions of 3–5, 6–9, 10–12 and ≥13 SABA (vs 1–2 ) were associated with increasingly lower odds of controlled or partly controlled asthma (odds ratio [95% CI]: 0.64 [0.53–0.78], 0.49 [0.39–0.61], 0.42 [0.34–0.51] and 0.33 [0.25–0.45], respectively; n=4597) and higher severe exacerbation rates (incidence rate ratio [95% CI]: 1.40 [1.24–1.58]; 1.52 [1.33–1.74]; 1.78 [1.57–2.02]; 1.92 [1.61–2.29], respectively; n=4612).
Conclusions: This study indicates an association between high SABA prescriptions and poor clinical outcomes across a broad range of countries, healthcare settings and asthma severities, providing support for initiatives to improve asthma morbidity by reducing SABA over-reliance.
Methods: SABINA III was a cross-sectional study that employed electronic case report forms at a study visit (in primary or specialist care) to record prescribed medication(s), over-the-counter (OTC) SABA purchase, and clinical outcomes in asthma patients (≥12 years old) during the past 12 months. In patients with ≥1 SABA prescription, associations of SABA with asthma symptom control and severe exacerbations were analysed using multivariable regression models.
Results: Of 8351 patients recruited (n=6872, specialists; n=1440, primary care), 76.5% had moderate-to-severe asthma and 45.4% experienced ≥1 severe exacerbation in the past 12 months. Thirty-eight percent of patients were prescribed ≥3 SABA canisters; 18.0% purchased OTC SABA, of whom 76.8% also received SABA prescriptions. Prescriptions of 3–5, 6–9, 10–12 and ≥13 SABA (vs 1–2 ) were associated with increasingly lower odds of controlled or partly controlled asthma (odds ratio [95% CI]: 0.64 [0.53–0.78], 0.49 [0.39–0.61], 0.42 [0.34–0.51] and 0.33 [0.25–0.45], respectively; n=4597) and higher severe exacerbation rates (incidence rate ratio [95% CI]: 1.40 [1.24–1.58]; 1.52 [1.33–1.74]; 1.78 [1.57–2.02]; 1.92 [1.61–2.29], respectively; n=4612).
Conclusions: This study indicates an association between high SABA prescriptions and poor clinical outcomes across a broad range of countries, healthcare settings and asthma severities, providing support for initiatives to improve asthma morbidity by reducing SABA over-reliance.
Original language | English |
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Number of pages | 13 |
Journal | European Respiratory Journal |
Volume | 59 |
Issue number | 5 |
Early online date | 24 Sept 2021 |
DOIs | |
Publication status | Published - 5 May 2022 |
Bibliographical note
Data sharingData underlying the findings described in this manuscript may be obtained in accordance with AstraZeneca’s data sharing policy described at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Acknowledgements
Editorial support was provided by Michelle Rebello, PhD, CMPP, of Cactus Life Sciences (part of Cactus Communications, Mumbai, India) in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3). This support was fully funded by AstraZeneca.
Support statement
AstraZeneca funded the study; was involved in the study design, protocol development, study conduct and statistical analysis; and was given the opportunity to review the manuscript before submission. AstraZeneca also funded medical writing support. All authors had full access to all the data, wrote the report and accept responsibility for its publication.
Keywords
- asthma
- global
- public health
- prescription
- short acting β2-agonist