Pedrozo-Pupo John Carlos, Pacheco Gallego Manuel Conrado, Baños Álvarez Iván de Jesús, Jaller Raad Rodolfo Antonio, Caballero Pinilla Andrea Carolina, Reynales Londoño Humberto, Bernal Villada Laura, Beekman Maarten
PREVICARE LTDA. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia.
División de Neumología y Endoscopia Respiratoria, Departamento de Medicina Interna, Universidad Tecnológica de Pereira, Universidad Visión de las Américas, RESPIREMOS Centro de Neumología y Endoscopia Respiratoria, Pereira, Colombia.
J Asthma Allergy. 2022 Aug 26;15:1167-1178. doi: 10.2147/JAA.S365009. eCollection 2022.
Overuse of short-acting β-agonists (SABAs) for asthma is associated with a significant increase in exacerbations and healthcare resource use. However, limited data exist on the extent of SABA overuse outside of Europe and North America. As part of the multi-country SABA use IN Asthma (SABINA) III study, we characterized SABA prescription patterns in Colombia.
This observational, cross-sectional cohort study of SABINA III included patients (aged ≥12 years) with asthma recruited from seven sites in Colombia. Demographics, disease characteristics (including investigator-defined asthma severity guided by the 2017 Global Initiative for Asthma report), and asthma treatments prescribed (including SABAs and inhaled corticosteroids [ICS]) in the 12 months preceding the study were recorded using electronic case report forms during a single study visit.
Of 250 patients analyzed, 50.4%, 33.2%, and 16.4% were enrolled by pulmonologists, general medicine practitioners, and allergists, respectively. Most patients were female (74.0%) and had moderate-to-severe asthma (67.6%). Asthma was partly controlled or uncontrolled in 57.6% of patients, with 15.6% experiencing ≥1 severe exacerbation 12 months before the study visit. In total, 4.0% of patients were prescribed SABA monotherapy and 55.6%, SABA in addition to maintenance therapy. Overall, 39.2% of patients were prescribed ≥3 SABA canisters in the 12 months before the study visit; 25.2% were prescribed ≥10 canisters. Additionally, 17.6% of patients purchased SABAs over the counter, of whom 43.2% purchased ≥3 canisters. Maintenance medication in the form of ICS or ICS/long-acting β-agonist fixed-dose combination was prescribed to 36.0% and 66.8% of patients, respectively.
Our findings suggest that prescription/purchase of ≥3 SABA canisters were common in Colombia, highlighting a public health concern. There is a need to improve asthma care by aligning clinical practices with the latest evidence-based treatment recommendations to improve asthma management across Colombia.
哮喘患者过度使用短效β受体激动剂（SABA）与病情加重及医疗资源使用显著增加相关。然而，欧洲和北美以外地区SABA过度使用程度的数据有限。作为多国哮喘患者SABA使用情况（SABINA）III研究的一部分，我们对哥伦比亚的SABA处方模式进行了描述。
SABINA III的这项观察性横断面队列研究纳入了从哥伦比亚7个地点招募的年龄≥12岁的哮喘患者。在单次研究访视期间，使用电子病例报告表记录研究前12个月的人口统计学信息、疾病特征（包括依据2017年全球哮喘防治创议报告由研究者定义的哮喘严重程度）以及所开具的哮喘治疗药物（包括SABA和吸入性糖皮质激素[ICS]）。
在分析的250例患者中，分别有50.4%、33.2%和16.4%由肺科医生、普通内科医生和过敏症专科医生纳入研究。大多数患者为女性（74.0%），患有中度至重度哮喘（67.6%）。57.6%的患者哮喘处于部分控制或未控制状态，15.6%的患者在研究访视前12个月经历过≥1次严重加重。总计，4.0%的患者被开具SABA单药治疗，55.6%的患者在维持治疗基础上加用SABA。总体而言，39.2%的患者在研究访视前12个月被开具≥3个SABA吸入器；25.2%的患者被开具≥10个吸入器。此外，17.6%的患者非处方购买SABA，其中43.2%购买了≥3个吸入器。分别有36.0%和66.8%的患者被开具ICS或ICS/长效β受体激动剂固定剂量复方制剂形式的维持药物。
我们的研究结果表明，在哥伦比亚，处方/购买≥3个SABA吸入器的情况很常见，这凸显了一个公共卫生问题。有必要通过使临床实践与最新的循证治疗建议保持一致来改善哮喘护理，以提升哥伦比亚的哮喘管理水平。
