PATIENTS WITH ASTHMA IN PRIMARY CARE VERSUS A SALBUTAMOL FREE ASTHMA CENTER OBSERVATIONAL STUDY

Abstract

Introduction. Given the evidence against the long-term use of short-acting beta₂ agonists (SABA), including increased risk of exacerbations and mortality, the Global Initiative for Asthma Report no longer recommends SABA-only therapy. Since 2014, we have implemented an Inhaled Corticosteroid (ICS)-containing reliever strategy (AIR/MART) at our asthma centre at the Baigorria Hospital in Argentina. We used budesonide/formoterol and eliminated the use of SABA therapy. The Asthma Referral Identifier Questionnaire (REFID) was designed to identify uncontrolled asthma that should be referred to a specialist.

Aims. To test whether a SABA-free asthma centre could have better asthma outcomes than a primary care SABA user.

Methods. REFID has 4 simple questions. It was applied between September 2020 and August 2021 in a public hospital in Buenos Aires, Argentina. The REFID was also run at the SABA-free asthma centre between December 2021 and January 2022.

Results. The SABA-free centre achieved significantly better outcomes, fewer systemic corticosteroid (SCS) courses and fewer Emergency Room visits (ER) for asthma exacerbations. All eleven individuals had been intubated before entering the SABA-free centre.

Conclusions. AIR/MART without SABA, plus asthma-specialist follow-up, significantly reduced SCS courses and ER visits compared to a SABA-user hospital primary care.