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

Andrea Yu-Lin Ban; Paranthaman Vengadasalam; Sri Wahyu Taher; Mohd Arif Mohd Zim; Syazatul Syakirin Sirol Aflah; Ummi Nadira Daut; Irfhan Ali Hyder Ali; Lalitha Pereirasamy; Azza Omar; Aishah Ibrahim; Noor Aliza Mohd Tarekh; Swee Kim Chan; Norsiah Ali; Nor Azila Mohd Isa; Husni Hussain; Noraziah Abdul Karim; Vieshal Raja Gopal; Sue Yin Chiam; Maarten JHI Beekman

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

Author: Andrea Yu-Lin Ban ¹ ; Paranthaman Vengadasalam ² ; Sri Wahyu Taher ³ ; Mohd Arif Mohd Zim ⁴ ; Syazatul Syakirin Sirol Aflah ⁵ ; Ummi Nadira Daut ⁶ ; Irfhan Ali Hyder Ali ⁷ ; Lalitha Pereirasamy ⁸ ; Azza Omar ⁹ ; Aishah Ibrahim ¹⁰ ; Noor Aliza Mohd Tarekh ¹¹ ; Swee Kim Chan ¹² ; Norsiah Ali ¹³ ; Nor Azila Mohd Isa ¹⁴ ; Husni Hussain ¹⁵ ; Noraziah Abdul Karim ¹⁶ ; Vieshal Raja Gopal ¹⁷ ; Sue Yin Chiam ¹⁸ ; Maarten J.H.I. Beekman ¹⁹
Author Information

1. MB Bch BAO (Ireland), MMed (UKM) Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia.
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
Publication Type:Journal Article
Keywords: Asthma; Asthma control; Severe exacerbations; Malaysia; Short-acting β2-agonist
MeSH: Asthma; Malaysia
From:Malaysian Family Physician 2023;18(All Issues):1-17
CountryMalaysia
Language:English
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.
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.
Full text:202508211414548915018.32R2OAShort-actingβ2-agonistprescriptionpatterns.pdf