Short-acting β2-agonist prescription patterns and clinical outcomes in Malaysia: A nationwide cohort of the SABINA III study

Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study...

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Published in:	Malaysian family physician Vol. 18; pp. 32 - 17
Main Authors:	Ban, Andrea Yu-Lin, Vengadasalam, Paranthaman, Taher, Sri Wahyu, Mohd Zim, Mohd Arif, Sirol Aflah, Syazatul Syakirin, Daut, Ummi Nadira, Hyder Ali, Irfhan Ali, Pereirasamy, Lalitha, Omar, Azza, Ibrahim, Aishah, Mohd Tarekh, Noor Aliza, Chan, Swee Kim, Ali, Norsiah, Mohd Isa, Nor Azila, Hussain, Husni, Abdul Karim, Noraziah, Raja Gopal, Vieshal, Chiam, Sue Yin, Beekman, Maarten J.H.I.
Format:	Journal Article
Language:	English
Published:	Kuala Lumpur Academy of Family Physicians of Malaysia 2023 Academy of Family Physician of Malaysia
Subjects:	Asthma asthma control Clinical outcomes Cross-sectional studies Health care Inhalers malaysia Original Patients Physicians Population Prescriptions Primary care Public health severe exacerbations short-acting β2-agonist Steroids Malaysia
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Summary:	Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study, patients (≥12 years) were recruited between July and December 2019 from 15 primary and specialty care centres in Malaysia. Prescribed asthma treatments and severe exacerbation history within 12 months prior and asthma symptom control during the study visit were evaluated. Associations of SABA prescription with asthma control and severe exacerbation were analysed using multivariable regression models. Results: Seven hundred thirty-one patients (primary care, n=265 [36.3%]; specialty care, n=466 [63.7%]) were evaluated. The prevalence of SABA over-prescription (≥3 SABA prescriptions/year) was 47.4% (primary care, 47.1%; specialty care, 47.6%), 51.8% and 44.5% among all patients and patients with mild and moderate-to-severe asthma, respectively. Altogether 9.0% (n=66) purchased SABA without a prescription; among them, 43.9% (n=29) purchased ≥3 inhalers. The mean (standard deviation) number of severe asthma exacerbations was 1.38 (2.76), and 19.7% (n=144) and 25.7% (n=188) had uncontrolled and partly controlled symptoms, respectively. Prescriptions of ≥3 SABA inhalers (vs 1–2) were associated with lower odds of at least partly controlled asthma (odds ratio=0.42; 95% confidence interval [CI]=0.27–0.67) and higher odds of having severe exacerbation(s) (odds ratio=2.04; 95% CI=1.44–2.89). Conclusion: The prevalence of SABA over-prescription in Malaysia is high, regardless of the prescriber type, emphasising the need for healthcare providers and policymakers to adopt latest evidence-based recommendations to address this public health concern.
ISSN:	1985-207X 1985-2274 1985-2274
DOI:	10.51866/oa.258