Few Adults With Moderate, Severe Asthma Receive Recommended Inhaler Regimen

Low number of patients treated based on the Single Maintenance and Reliever Therapy (SMART) guideline
asthma inhaler
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Medically Reviewed By:
Mark Arredondo, M.D.

THURSDAY, May 23, 2024 (HealthDay News) -- Only 14.5 percent of adult patients with moderate or severe asthma are prescribed the recommended Single Maintenance and Reliever Therapy (SMART) inhaler regimen, according to a study presented at the American Thoracic Society 2024 International Conference, held from May 17 to 22 in San Diego.

Zoe Zimmerman, from the Yale School of Medicine in New Haven, Connecticut, and colleagues used electronic medical records to identify 2,016 patients with at least one visit to a pulmonary or allergy clinic (January 2021 to August 2023), a diagnosis of asthma, and a prescription of a maintenance inhaler containing a combination corticosteroid and formoterol (ICS-LABA) inhaler or ICS alone.

The researchers found that 14.5 percent of patients were prescribed SMART (ICS-LABA for maintenance and relief therapy). Almost 90 percent of the patients prescribed SMART were also prescribed a rescue inhaler such as albuterol. Patients prescribed ICS-LABA as a baseline maintenance inhaler were more likely to be prescribed SMART. Older age and being a Medicare beneficiary were associated with not being prescribed SMART.

"Our findings suggest current asthma management guidelines are not being routinely implemented or adopted by clinicians," senior author Sandra Zaeh, M.D., also from Yale, said in a statement. "While physician education about the benefits of SMART is important, we suspect that other barriers to SMART implementation need to be addressed -- for example, insurance formulary coverage, patient education strategies to transition to SMART, and clinician support to assist with SMART adoption (i.e., assistance from a pharmacist to navigate challenges and development of clinical decision support tools)."


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