Montero-Arias Felicia, Garcia Jose Carlos Herrera, Gallego Manuel Pacheco, Antila Martti Anton, Schonffeldt Patricia, Mattarucco Walter Javier, Gallegos Luis Fernando Tejado, Beekman Maarten J H I
Servicio de Neumología, Hospital México, CCSS y Hospital Clínica Bíblica Santa Ana, San José, Costa Rica.
Pulmonary Function Unit, Unidad de Funcion Pulmonar, Unidad de investigación Clínica de Puebla, UISP Unidad de Investigación y Salud de Puebla, Puebla, Mexico.
J Asthma. 2023 Mar;60(3):574-587. doi: 10.1080/02770903.2022.2082305. Epub 2022 Jun 20.
Short-acting β-agonist (SABA) over-reliance is associated with poor asthma outcomes. As part of the SABA Use IN Asthma (SABINA) III study, we assessed SABA prescriptions and clinical outcomes in patients from six Latin American countries.
In this cross-sectional study, data on disease characteristics/asthma treatments were collected using electronic case report forms. Patients (aged ≥12 years) were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma) and practice type (primary/specialist care). Multivariable regression models analyzed the associations between SABA prescriptions and clinical outcomes.
Data from 1096 patients (mean age, 52.0 years) were analyzed. Most patients were female (70%), had moderate-to-severe asthma (79.4%), and were treated by specialists (87.6%). Asthma was partly controlled/uncontrolled in 61.5% of patients; 47.4% experienced ≥1 severe exacerbation in the previous 12 months. Overall, 39.8% of patients were prescribed ≥3 SABA canisters in the preceding 12 months (considered over-prescription). SABA canisters were purchased over the counter (OTC) by 17.2% of patients, of whom 38.8% purchased ≥3 canisters in the 12 months prior. Of patients who purchased SABA OTC, 73.5% were prescribed ≥3 SABA canisters. Higher SABA prescriptions (vs. 1 - 2 canisters) were associated with an increased incidence rate of severe exacerbations (ranging from 1.31 to 3.08) and lower odds ratios of having at least partly controlled asthma (ranging from 0.63 to 0.15).
SABA over-prescription was common in Latin America, highlighting the need for urgent collaboration between healthcare providers and policymakers to align clinical practices with the latest evidence-based recommendations to address this public health concern.
过度依赖短效β受体激动剂（SABA）与哮喘不良预后相关。作为哮喘中SABA使用（SABINA）III研究的一部分，我们评估了来自六个拉丁美洲国家患者的SABA处方和临床结局。
在这项横断面研究中，使用电子病例报告表收集疾病特征/哮喘治疗的数据。患者（年龄≥12岁）根据研究者定义的哮喘严重程度（以2017年全球哮喘防治创议为指导）和执业类型（初级/专科护理）进行分类。多变量回归模型分析了SABA处方与临床结局之间的关联。
分析了1096例患者（平均年龄52.0岁）的数据。大多数患者为女性（70%），患有中度至重度哮喘（79.4%），并由专科医生治疗（87.6%）。61.5%的患者哮喘得到部分控制/未得到控制；47.4%的患者在过去12个月中经历了≥1次严重加重。总体而言，39.8%的患者在过去12个月中被处方≥3个SABA吸入器（被视为处方过量）。17.2%的患者通过非处方（OTC）购买SABA吸入器，其中38.8%的患者在之前12个月内购买了≥3个吸入器。在购买OTC SABA的患者中，73.5%被处方≥3个SABA吸入器。较高的SABA处方量（与1 - 2个吸入器相比）与严重加重的发生率增加（范围为1.31至3.08）以及哮喘至少得到部分控制的较低比值比（范围为0.63至0.15）相关。
SABA处方过量在拉丁美洲很常见，这突出表明医疗保健提供者和政策制定者需要紧急合作，使临床实践与最新的循证建议保持一致，以解决这一公共卫生问题。
