SABA prescriptions and asthma management practices in patients treated by specialists in Taiwan: Results from the SABINA III study.

PURPOSE: Limited data exist on asthma medication patterns in Taiwan. The objectives of the SABINA III cross-sectional study in Taiwan were thus, to describe patient demographics and clinical features and estimate short-acting ß2-agonist (SABA) and inhaled corticosteroids (ICS) prescriptions per patient. METHODS: Patients (≥18 years) with asthma were classified by investigator-defined asthma severity per the 2017 Global Initiative for Asthma (GINA) recommendations. Data on asthma symptom control (per GINA 2017 recommendations), severe exacerbation history, and prescribed treatments in the 12 months before study visit were collected using electronic case-report forms. Analyses were descriptive. RESULTS: Overall, all 294 analyzed patients (mean [SD] age, 57.9 [15.6] years; female, 69%) were enrolled by specialists and had fully reimbursed healthcare. Most patients were classified with moderate-to-severe asthma (93.2%; GINA steps 3-5), were obese (53.4%) and nonsmokers (79.6%), reported high school or university and/or postgraduate education (61.9%), and had ≤2 comorbidities (89.1%). Mean (SD) asthma duration was 8.3 (10.0) years, with 37.8% of patients experiencing ≥1 severe exacerbation 12 months before the study visit. Overall, 62.2%, 26.2%, and 11.6% of patients had well-controlled, partly controlled, and uncontrolled asthma, respectively. Crucially, 19.3% of patients were prescribed ≥3 SABA canisters in the preceding 12 months (overprescription). ICS, ICS + long-acting ß2-agonist fixed-dose combination, and oral corticosteroid bursts were prescribed to 6.5%, 97.3%, and 31.6% of patients, respectively. CONCLUSION: Despite treatment by specialists and fully reimbursed healthcare, findings indicate room for improvement in asthma control and SABA prescription practices in Taiwan, emphasizing the need to adhere to latest evidence-based guidelines.

Overprescription of short-acting ß2-agonists is associated with poor asthma symptom control: results from five Middle Eastern countries included in the SABINA International (III) study.

BACKGROUND: Although short-acting ß2-agonist (SABA) overuse is associated with poor treatment outcomes, data on SABA use in the Middle East are lacking. RESEARCH DESIGN AND METHODS: In this cross-sectional study in patients (aged ≥12 years) with asthma, data on disease characteristics and asthma treatments were collected from the Middle Eastern cohort of the SABA use IN Asthma (SABINA) III study. Patients were classified by investigator-defined asthma severity and practice type. Multivariable regression models analyzed the association between SABA prescriptions and clinical outcomes. RESULTS: Of 1389 patients (mean age, 46.7 years; female, 69.5%), 85.7% had moderate-to-severe asthma and 88.7% were treated by specialists. Overall, 51.3% of patients experienced ≥1 severe asthma exacerbation in the previous 12 months, with 58.2% having partly controlled or uncontrolled asthma. Notably, 47.1% of patients were prescribed ≥3 SABA canisters (considered overprescription). SABA canisters were purchased over the counter by 15.3% of patients. Higher SABA prescriptions (vs 1-2 canisters), except 3-5 canisters, were associated with increased odds of uncontrolled asthma (p < 0.05). CONCLUSIONS: SABA overprescription occurred in almost half of all patients in the Middle East, underscoring the need for healthcare providers and policymakers to adhere to the latest evidence-based recommendations to address this public health concern.

Asthma is a long-term disease that causes inflammation of the airways in the lungs and affects both adults and children. Despite effective medicines, asthma remains poorly controlled in many patients. Inhaled steroids with anti-inflammatory properties are the most effective controller medications for asthma. However, many patients rely on rescue or reliever medications, including short-acting ß₂-agonists (SABAs), as they provide immediate relief from symptoms. However, SABAs do not treat the underlying inflammation of asthma and their continued overuse may place patients at risk of asthma attacks and hospitalization. The SABA use IN Asthma study, known as SABINA, examined SABA prescriptions in patients with asthma in 24 countries across five continents. As part of this study, data were collected on prescriptions for asthma medications (including SABA prescriptions) and the purchase of SABA over-the-counter (OTC) at the pharmacy without a prescription from 1389 patients aged at least 12 years across five countries in the Middle East (United Arab Emirates, Kuwait, Oman, Saudi Arabia, and Turkey). Nearly half of all patients were prescribed three or more SABA canisters in the previous 12 months, which is above that recommended by asthma treatment guidelines. SABA was also purchased OTC without a prescription by approximately 15% of patients, a majority of whom had already received a high number of SABA prescriptions. Prescription of six or more SABA canisters was associated with poor asthma control. Therefore, there is an urgent need for healthcare providers to follow the latest treatment guidelines for asthma to reduce SABA prescriptions.