Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Wuping Bao; Yingying Zhang; Jingqing Hang; Yubiao Guo; Wei Tang; Chunmei Yun; Jingmin Deng; Meiling Jin; Kefang Lai; Huapeng Yu; Maarten Beekman; Xin Zhou; Min Zhang

doi:10.1177/17534666221115054

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Ther Adv Respir Dis. 2022 Jan-Dec:16:17534666221115054. doi: 10.1177/17534666221115054.

Authors

Wuping Bao¹, Yingying Zhang¹, Jingqing Hang², Yubiao Guo³, Wei Tang⁴, Chunmei Yun⁵, Jingmin Deng⁶, Meiling Jin⁷, Kefang Lai⁸, Huapeng Yu⁹, Maarten Beekman¹⁰, Xin Zhou¹¹, Min Zhang¹¹

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
² Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District People's Hospital, Shanghai, China.
³ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁴ Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁵ Department of Pulmonary and Critical Care Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China.
⁶ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
⁷ Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
⁸ State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁹ Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
¹⁰ International Medical Respiratory & Immunology, AstraZeneca Netherlands, The Hague, The Netherlands.
¹¹ Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, No. 100, Haining Road, Shanghai 200080, China.

Abstract

Objectives: The SABINA CHINA study aimed to determine prescription data for asthma medication with a focus on SABA and ICS in a representative population of patients with asthma in China.

Methods: SABINA China was a multicentre, observational, cross-sectional study with data collected retrospectively from a convenience sample of 25 tertiary centres across China. Patients (age ⩾ 12 years) with ⩾3 consultations/year were enrolled. Data were collected on clinical characteristics, asthma severity, and symptom control (as per GINA 2017), treatment and history of severe exacerbations over the past year. SABA over-prescription was defined as ⩾3 SABA canisters/year. Descriptive statistics are presented.

Results: Between March and August 2020, 498 patients were included in the outcome analysis. Mean (SD) age was 48.7 (15.0) years, 57.9% were female and 91% had moderate-to-severe asthma (n = 453). Overall, 12.5% (n = 62) and 26.4% (n = 131) of patients had uncontrolled and partly controlled asthma, respectively. SABA add-on was prescribed to 20.3% (n = 101) of patients; one patient with moderate-to-severe asthma was prescribed SABA-alone. SABA over-prescription in the overall population was 4.0% (n = 20; all with moderate-to-severe asthma) and 19.8% (20/101) among those prescribed SABA add-on. In the mild asthma group, 50% (n = 22) were prescribed ICS/LABA and 43.2% (n = 19) were prescribed LTRA. Among those with moderate-to-severe asthma, 97.4% (n = 441) were prescribed ICS/LABA and 55.0% (n = 249) were prescribed LTRA. Approximately 30% of patients (n = 149) experienced ⩾1% and 6.6% (n = 33) ⩾3 severe exacerbations in the preceding year; mean annual number of severe exacerbation/patient was 0.6 (1.2). Among those prescribed SABA add-on, ICS/LABA and LTRA (non-mutually exclusive groups due to overlapping prescriptions), 54.5%, 29.9%, and 35.3% had ⩾1 severe exacerbations, respectively.

Conclusion: Among patients with predominantly moderate-to-severe asthma managed in tertiary care and were prescribed SABA, 1 in 5 received ⩾3 canisters/year. Fewer patients who received ICS/LABA prescriptions experienced annual exacerbations than those prescribed SABA add-on.

Keywords: China; ICS; SABA; SABINA; asthma; exacerbation; over-prescription; overuse.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Inhalation
Adrenal Cortex Hormones / therapeutic use
Anti-Asthmatic Agents* / adverse effects
Asthma* / diagnosis
Asthma* / drug therapy
Asthma* / epidemiology
Child
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Prescriptions
Retrospective Studies

Substances

Adrenal Cortex Hormones
Anti-Asthmatic Agents