A Cross-Sectional Study on Prescription Patterns of Short-Acting β2-Agonists in Patients with Asthma: Results from the SABINA III Colombia Cohort

Abstract

John Carlos Pedrozo-Pupo,1 Manuel Conrado Pacheco Gallego,2 Iván de Jesús Baños Álvarez,3 Rodolfo Antonio Jaller Raad,4 Andrea Carolina Caballero Pinilla,5 Humberto Reynales Londoño,6 Laura Bernal Villada,7 Maarten Beekman8 1PREVICARE LTDA. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia; 2División 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; 3Centro de Rehabilitación Pulmonar Integral S.A.S., Cartagena, Colombia; 4Department of Allergy and Immunology, Centro de Investigación Médico Asistencial S.A.S, Barranquilla, Colombia; 5Centro de Investigación Clínica, Caja de Compensación Familiar CAFAM, Sede Centro de Atención en Salud CAFAM Floresta, Bogotá, Colombia; 6Clinical Research Department, Centro de Atención e Investigación Médica - CAIMED, Chía, Colombia; 7Andean Cluster - Respiratory & Immunology, AstraZeneca, Bogotá, Colombia; 8Respiratory & Immunology AstraZeneca, The Hague, the NetherlandsCorrespondence: John Carlos Pedrozo-Pupo, PREVICARE LTDA. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia, Tel [phone], Email [email protected]: Overuse of short-acting β2-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.Patients and Methods: 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.Results: 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 β2-agonist fixed-dose combination was prescribed to 36.0% and 66.8% of patients, respectively.Conclusion: 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.Keywords: exacerbations, inhaled corticosteroids, over-prescription, practice patterns, prescriptions

Keywords

• exacerbations
• inhaled corticosteroids
• over-prescription
• practice patterns
• prescriptions