1.Short-acting β2-agonist prescription patterns and clinical outcomes in Malaysia: A nationwide cohort of the SABINA III study
Andrea Ban Yu-Lin ; Paranthaman Vengadasalam ; Sri Wahyu Taher ; Mohd Arif Mohd Zim ; Syazatul Syakirin Sirol A ah ; 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 J.H.I. Beekman
Malaysian Family Physician 2023;18():1-17
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. e 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. e 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% con dence 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: e 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.
Result Analysis
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