Overprescription of short-acting β2-agonists is associated with poor asthma symptom control: results from five Middle Eastern countries included in the SABINA International (III) study

Abstract

Background: Although short-acting β2-agonist (SABA) overuse is associated with poor treatment outcomes, data on SABA use in the Middle East are lacking. Research design and methods: In this cross-sectional study in patients (aged ≥12 years) with asthma, data on disease characteristics and asthma treatments were collected from the Middle Eastern cohort of the SABA use IN Asthma (SABINA) III study. Patients were classified by investigator-defined asthma severity and practice type. Multivariable regression models analyzed the association between SABA prescriptions and clinical outcomes. Results: Of 1389 patients (mean age, 46.7 years; female, 69.5%), 85.7% had moderate-to-severe asthma and 88.7% were treated by specialists. Overall, 51.3% of patients experienced ≥1 severe asthma exacerbation in the previous 12 months, with 58.2% having partly controlled or uncontrolled asthma. Notably, 47.1% of patients were prescribed ≥3 SABA canisters (considered overprescription). SABA canisters were purchased over the counter by 15.3% of patients. Higher SABA prescriptions (vs 1–2 canisters), except 3–5 canisters, were associated with increased odds of uncontrolled asthma (p < 0.05). Conclusions: SABA overprescription occurred in almost half of all patients in the Middle East, underscoring the need for healthcare providers and policymakers to adhere to the latest evidence-based recommendations to address this public health concern.