Expert Consensus on SABA Use for Asthma Clinical Decision-Making: A Delphi Approach-Reference-Cited by-同舟云学术

Expert Consensus on SABA Use for Asthma Clinical Decision-Making: A Delphi Approach

Published:2023-11 Issue:11 Volume:23 Page:621-634
ISSN:1529-7322
Container-title:Current Allergy and Asthma Reports
language:en
Short-container-title:Curr Allergy Asthma Rep

Author:

Lugogo Njira,O’Connor Maeve,George Maureen,Merchant Rajan,Bensch Greg,Portnoy Jay,Oppenheimer John,Castro Mario

Abstract

Abstract Purpose of Review A modified Delphi process was undertaken to provide a US expert-led consensus to guide clinical action on short-acting beta2-agonist (SABA) use. This comprised an online survey (Phase 1), forum discussion and statement development (Phase 2), and statement adjudication (Phase 3). Recent Findings In Phase 1 (n = 100 clinicians), 12% routinely provided patients with ≥4 SABA prescriptions/year, 73% solicited SABA use frequency at every patient visit, and 21% did not consult asthma guidelines/expert reports. Phase 3 experts (n = 8) reached consensus (median Likert score, interquartile range) that use of ≥3 SABA canisters/year is associated with increased risk of exacerbation and asthma-related death (5, 4.75–5); SABA use history should be solicited at every patient visit (5, 4.75–5); usage patterns over time, not absolute thresholds, should guide response to SABA overuse (5, 4.5–5). Summary Future asthma guidelines should include clear recommendations regarding SABA usage, using expert-led thresholds for action.

Funder

This study and medical writing support of this article were funded by Teva Pharmaceuticals.

Publisher

Springer Science and Business Media LLC

Subject

Pulmonary and Respiratory Medicine,Immunology and Allergy,Immunology

Link

https://link.springer.com/content/pdf/10.1007/s11882-023-01111-z.pdf

Reference61 articles.

1. Centers for Disease Control and Prevention. Most recent national asthma data. 2021. Accessed September 27, 2023. https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm.

2. Amin S, Soliman M, McIvor A, Cave A, Cabrera C. Usage patterns of short-acting β(2)-agonists and inhaled corticosteroids in asthma: a targeted literature review. J Allergy Clin Immunol Pract. 2020;8(8):2556-64.e8.

3. Azzi EA, Kritikos V, Peters MJ, Price DB, Srour P, Cvetkovski B, et al. Understanding reliever overuse in patients purchasing over-the-counter short-acting beta(2) agonists: an Australian community pharmacy-based survey. BMJ Open. 2019;9(8): e028995.

4. Bloom CI, Cabrera C, Arnetorp S, Coulton K, Nan C, van der Valk RJP, et al. Asthma-related health outcomes associated with short-acting β(2)-agonist inhaler use: an observational UK study as part of the SABINA global program. Adv Ther. 2020;37(10):4190–208.

5. •• Lugogo N, Gilbert I, Tkacz J, Gandhi H, Goshi N, Lanz MJ. Real-world patterns and implications of short-acting β(2)-agonist use in patients with asthma in the United States. Ann Allergy Asthma Immunol. 2021; 126(6):681-9.e1. Analysis of administrative claims data from 135,540 US asthma patients found that exacerbation risk increased with increasing SABA fills.