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Abstract：
OBJECTIVE: To evaluate asthma characteristics and treatment patterns, including short-acting β2-agonist (SABA) prescriptions, in primary and specialist care in the Singapore cohort of the SABA use IN Asthma (SABINA III) study.
METHODS: Cross-sectional, observational study.
METHODS: Multicentre study conducted at five sites across Singapore.
METHODS: In patients with asthma (aged ≥12 years), data on demographics, disease characteristics and asthma treatment prescriptions were collected using electronic case report forms. Patients were classified by investigator-defined asthma severity (guided by 2017 Global Initiative for Asthma recommendations) and practice type (primary/specialist care).
RESULTS: Of the 205 patients analysed (mean (SD) age, 53.6 (16.8) years; female, 62%), 55.9% were enrolled by specialists and 44.1% by primary care physicians. Most study patients (80.5%) had moderate-to-severe asthma (86.0% in specialist care and 74.4% in primary care). In the 12 months before study enrolment, 18.0% of patients experienced ≥1 severe exacerbation. Asthma was well or partly controlled in 78.0% of patients. Overall, 17.1% of all patients were overprescribed SABA (≥3 SABA canisters/year) in the preceding 12 months, and overprescription was greater in specialist versus primary care (26.3% vs 5.6%). Only 2.9% of patients were prescribed SABA monotherapy, while 41.0% received SABA in addition to maintenance therapy. Among the latter, 40.5% were overprescribed SABA. Overall, a higher percentage of patients prescribed ≥3 SABA canisters (vs 0-2 SABA canisters) were assessed as having uncontrolled asthma during the study visit (42.9% vs 17.6%). Maintenance therapy in the form of inhaled corticosteroids (ICS) or ICS/long-acting β2 agonist fixed-dose combinations were prescribed to 14.1% and 84.9% of patients, respectively, in the 12 months before enrolment.
CONCLUSIONS: In this Singapore cohort, ~17% of all patients and more than 40% of patients prescribed SABA in addition to maintenance therapy were overprescribed SABA. These findings emphasise the need to align clinical practices with the latest evidence-based treatment recommendations.
BACKGROUND: NCT03857178.
METHODS: Cross-sectional, observational study.
METHODS: Multicentre study conducted at five sites across Singapore.
METHODS: In patients with asthma (aged ≥12 years), data on demographics, disease characteristics and asthma treatment prescriptions were collected using electronic case report forms. Patients were classified by investigator-defined asthma severity (guided by 2017 Global Initiative for Asthma recommendations) and practice type (primary/specialist care).
RESULTS: Of the 205 patients analysed (mean (SD) age, 53.6 (16.8) years; female, 62%), 55.9% were enrolled by specialists and 44.1% by primary care physicians. Most study patients (80.5%) had moderate-to-severe asthma (86.0% in specialist care and 74.4% in primary care). In the 12 months before study enrolment, 18.0% of patients experienced ≥1 severe exacerbation. Asthma was well or partly controlled in 78.0% of patients. Overall, 17.1% of all patients were overprescribed SABA (≥3 SABA canisters/year) in the preceding 12 months, and overprescription was greater in specialist versus primary care (26.3% vs 5.6%). Only 2.9% of patients were prescribed SABA monotherapy, while 41.0% received SABA in addition to maintenance therapy. Among the latter, 40.5% were overprescribed SABA. Overall, a higher percentage of patients prescribed ≥3 SABA canisters (vs 0-2 SABA canisters) were assessed as having uncontrolled asthma during the study visit (42.9% vs 17.6%). Maintenance therapy in the form of inhaled corticosteroids (ICS) or ICS/long-acting β2 agonist fixed-dose combinations were prescribed to 14.1% and 84.9% of patients, respectively, in the 12 months before enrolment.
CONCLUSIONS: In this Singapore cohort, ~17% of all patients and more than 40% of patients prescribed SABA in addition to maintenance therapy were overprescribed SABA. These findings emphasise the need to align clinical practices with the latest evidence-based treatment recommendations.
BACKGROUND: NCT03857178.
摘要：
目的：评估哮喘的特点和治疗模式，包括短效β2激动剂（SABA）处方，在SABA在哮喘中使用（SABINAIII）研究的新加坡队列中的初级和专科护理。
方法：横截面，观察性研究。
方法：在新加坡的五个地点进行的多中心研究。
方法：哮喘患者（年龄≥12岁），人口统计数据，使用电子病例报告表收集疾病特征和哮喘治疗处方。患者根据研究者定义的哮喘严重程度（2017年全球哮喘倡议建议指导）和实践类型（初级/专科护理）进行分类。
结果：在分析的205例患者中（平均（SD）年龄，53.6（16.8）岁；女性，62%），55.9%由专科医生登记，44.1%由初级保健医生登记。大多数研究患者（80.5%）患有中度至重度哮喘（86.0%为专科护理，74.4%为初级护理）。在入学前的12个月里，18.0%的患者经历了≥1次严重加重。78.0%的患者哮喘得到良好或部分控制。总的来说,在过去的12个月中，所有患者中有17.1％的患者被处方超过SABA（≥3SABA罐/年），与初级保健相比,专科护理中的过度处方更大(26.3%vs5.6%).只有2.9%的患者接受SABA单药治疗，而41.0％的人除了维持治疗外还接受SABA治疗。在后者中,40.5％的人被过量使用SABA。总的来说,在研究访视期间,处方≥3个SABA罐(vs0-2个SABA罐)的患者被评估为哮喘未控制的比例较高(42.9%vs17.6%).14.1％和84.9％的患者采用吸入性皮质类固醇（ICS）或ICS/长效β2激动剂固定剂量组合形式的维持治疗，分别,在入学前的12个月。
结论：在这个新加坡队列中，除了维持治疗外，〜17％的所有患者和超过40％的患者都处方SABA过量。这些发现强调需要将临床实践与最新的循证治疗建议保持一致。
背景：NCT03857178。
方法：横截面，观察性研究。
方法：在新加坡的五个地点进行的多中心研究。
方法：哮喘患者（年龄≥12岁），人口统计数据，使用电子病例报告表收集疾病特征和哮喘治疗处方。患者根据研究者定义的哮喘严重程度（2017年全球哮喘倡议建议指导）和实践类型（初级/专科护理）进行分类。
结果：在分析的205例患者中（平均（SD）年龄，53.6（16.8）岁；女性，62%），55.9%由专科医生登记，44.1%由初级保健医生登记。大多数研究患者（80.5%）患有中度至重度哮喘（86.0%为专科护理，74.4%为初级护理）。在入学前的12个月里，18.0%的患者经历了≥1次严重加重。78.0%的患者哮喘得到良好或部分控制。总的来说,在过去的12个月中，所有患者中有17.1％的患者被处方超过SABA（≥3SABA罐/年），与初级保健相比,专科护理中的过度处方更大(26.3%vs5.6%).只有2.9%的患者接受SABA单药治疗，而41.0％的人除了维持治疗外还接受SABA治疗。在后者中,40.5％的人被过量使用SABA。总的来说,在研究访视期间,处方≥3个SABA罐(vs0-2个SABA罐)的患者被评估为哮喘未控制的比例较高(42.9%vs17.6%).14.1％和84.9％的患者采用吸入性皮质类固醇（ICS）或ICS/长效β2激动剂固定剂量组合形式的维持治疗，分别,在入学前的12个月。
结论：在这个新加坡队列中，除了维持治疗外，〜17％的所有患者和超过40％的患者都处方SABA过量。这些发现强调需要将临床实践与最新的循证治疗建议保持一致。
背景：NCT03857178。
