Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Division of Pulmonology, Department of Medicine, Hat Yai Medical Education Center Hatyai Hospital, Songkhla, Thailand.
J Asthma. 2023 Dec;60(12):2177-2188. doi: 10.1080/02770903.2023.2228895. Epub 2023 Jul 5.
Short-acting β-agonist (SABA) overuse is associated with poor asthma outcomes; however, the extent of SABA use in Thailand is largely unknown. As part of the SABA use IN Asthma (SABINA) III study, we describe asthma treatment patterns, including SABA prescriptions, in patients treated by specialists in Thailand.
In this observational, cross-sectional study, patients (aged ≥12 years) with an asthma diagnosis were recruited by specialists from three Thai tertiary care centers using purposive sampling. Patients were classified by investigator-defined asthma severity (per 2017 Global Initiative for Asthma [GINA] recommendations). Data on sociodemographics, disease characteristics, and asthma treatment prescriptions were collected from existing medical records by healthcare providers and transcribed onto electronic case report forms. Analyses were descriptive.
All 385 analyzed patients (mean age: 57.6 years; 69.6% female) were treated by specialists. Almost all (91.2%) patients were classified with moderate-to-severe asthma (GINA treatment steps 3-5), 69.1% were overweight/obese, and 99.7% reported partially/fully reimbursed healthcare. Asthma was partly controlled/uncontrolled in 24.2% of patients; 23.1% experienced ≥1 severe asthma exacerbation in the preceding 12 months. Overall, SABAs were over-prescribed (≥3 canisters/year) in 28.3% of patients. Inhaled corticosteroids (ICS), ICS/long-acting β-agonists, oral corticosteroid (OCS) burst treatment, and long-term OCS were prescribed to 7.0, 93.2, 19.2, and 6.2% of patients, respectively. Additionally, 4.2% of patients reported purchasing SABA over the counter.
Despite receiving specialist treatment, 28.3% of patients were over-prescribed to SABA in the previous 12 months, highlighting a public health concern and the need to align clinical practices with current evidence-based recommendations.
短效 β-激动剂（SABA）的过度使用与不良哮喘结局相关；然而，泰国 SABA 的使用程度在很大程度上尚不清楚。作为 SABA 使用在哮喘中的研究（SABINA）III 研究的一部分，我们描述了在泰国接受专科医生治疗的患者的哮喘治疗模式，包括 SABA 处方。
在这项观察性、横断面研究中，专科医生通过选择性抽样从泰国的三个三级护理中心招募了年龄≥12 岁的哮喘诊断患者。根据 2017 年全球哮喘倡议（GINA）建议，患者被研究者定义的哮喘严重程度分类。医护人员从现有病历中收集社会人口统计学、疾病特征和哮喘治疗处方的数据，并转录到电子病例报告表中。分析是描述性的。
所有 385 名分析患者（平均年龄：57.6 岁；69.6%女性）均由专科医生治疗。几乎所有（91.2%）患者被归类为中重度哮喘（GINA 治疗步骤 3-5），69.1%超重/肥胖，99.7%报告部分/全额报销医疗保健。24.2%的患者哮喘部分控制/未控制；23.1%的患者在过去 12 个月内经历过≥1 次严重哮喘加重。总体而言，28.3%的患者 SABA 处方过量（≥3 罐/年）。吸入性皮质类固醇（ICS）、ICS/长效 β-激动剂、口服皮质类固醇（OCS）爆发治疗和长期 OCS 分别处方给 7.0%、93.2%、19.2%和 6.2%的患者。此外，4.2%的患者报告在非处方购买 SABA。
尽管接受了专科治疗，但在过去 12 个月内，仍有 28.3%的患者 SABA 处方过量，这突显了一个公共卫生问题，需要使临床实践与当前基于证据的建议保持一致。
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