Fulltext

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

Ban AY 1 , Vengadasalam P 2 , Taher SW 3 , Mohd Zim MA 4 , Sirol Aflah SS 5 , Daut UN 6 Show all authors , Hyder Ali IA 7 , Pereirasamy L 8 , Omar A 9 , Ibrahim A 10 , Mohd Tarekh NA 11 , Chan SK 12 , Ali N 13 , Mohd Isa NA 14 , Hussain H 15 , Abdul Karim N 16 , Raja Gopal V 17 , Chiam SY 18 , Beekman MJHI 19

Affiliations 

  • 1 MB Bch BAO (Ireland), MMed (UKM), Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia. Email: [email protected]
  • 2 MBBS (UM), MMed (UM), Klinik Kesihatan Greentown, Jalan Raja Musa Aziz, Ipoh, Perak, Malaysia
  • 3 MBChB (Glasgow), MMed (UKM), Klinik Kesihatan Simpang Kuala, Jalan Kuala Kedah, Simpang Kuala, Alor Star, Kedah Darul Aman, Malaysia
  • 4 MB BCh BAO (Ireland), MMed (UM), KPJ Damansara Specialist Hospital 2, Bukit Lanjan, Kuala Lumpur, Malaysia
  • 5 MD (UKM), MRCP (UK), Institut Perubatan Respiratori, Jalan Pahang Kuala Lumpur, Kuala Lumpur, Malaysia
  • 6 MD (USM), MMed (UKM), Universiti Putra Malaysia, Jalan Universiti 1, Serdang, Selangor Darul Ehsan, Malaysia
  • 7 MBBS (UM), MMed (UKM), Hospital Pulau Pinang, Jalan Residensi Georgetown, Pulau Pinang, Malaysia
  • 8 MD (USM), MMed (UKM), MRCP (Ireland), Hospital Pulau Pinang, Jalan Residensi Georgetown, Pulau Pinang, Malaysia
  • 9 MD (USM), MMed (USM), Hospital Raja Perempuan Zainab II, Bandar Kota Bharu, Kota Bharu, Kelantan, Malaysia
  • 10 MBBS (UM), MMed (UM), Hospital Tengku Ampuan Afzan, Jalan Tanah Putih, Kuantan, Pahang Darul Makmur, Malaysia
  • 11 MD (USM), MMed (UKM), KPJ Puteri Specialist Hospital, 33, Jalan Tun Abdul Razak (Susur 5), Johor Bahru, Johor, Malaysia
  • 12 MD (UniMAS), MRCP (UK), Hospital Umum Sarawak, Jalan Hospital Kuching, Sarawak, Malaysia
  • 13 MD (USM), MMed (UM), Klinik Kesihatan Masjid Tanah, Jalan Besar Masjid Tanah, Masjid Tanah, Melaka, Malaysia
  • 14 MBBS (UM), MMed (UKM), Klinik Kesihatan Nilai, Jalan Besar, Nilai, Pekan Nilai, Seremban, Negeri Sembilan, Malaysia
  • 15 MBBS (UKM), MMed (UKM), Klinik Kesihatan Salak, Jalan Salak, Sepang, Selangor Darul Ehsan, Malaysia
  • 16 MD (UPM), Klinik Kesihatan Salak, Jalan Salak, Sepang, Selangor Darul Ehsan, Malaysia
  • 17 MD (Ukraine) AstraZeneca, United Kingdom
  • 18 BSc (UK), Medical Affairs, AstraZeneca, Malaysia
  • 19 MD (Netherlands), BPharm (Netherlands), AstraZeneca, The Hague, The Netherlands
Malays Fam Physician, 2023;18:32.
PMID: 37292227 DOI: 10.51866/oa.258

Abstract

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.

METHOD: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications