satisfaction levels and asthma control amongst malaysian asthmatic patients on budesonide/formoterol maintenance and reliever therapy: experience in a real-life setting

Roslina Abdul Manap,1 Li Cher Loh,2 Tengku Saifudin Tengku Ismail,3 Abdul Razak Muttalif,4 George Kutty Simon,5 Rosalind Beng Hong Toh,6 Mohd Razali Norhaya,7 Noor Aliza Md Tarekh,8 Che Wan Aminuddin Hashim,9 Mohammad Fauzi Abdul Rani,10 Aziah Ahmad Mahayiddin111Department of Medicine, UniversitiKebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; 2Department of Medicine, Penang Medical College, Penang, Malaysia; 3Department of Medicine, Faculty of Medicine UniversitiInstitutTeknologi MARA, Selangor, Malaysia; 4Department of Respiratory Medicine, Penang Hospital, Penang, Malaysia; 5Department of Respiratory Medicine, Hospital SultanahBahiyah, Alor Star, Kedah, Malaysia; 6Hospital Ipoh, Ipoh, Malaysia; 7Hospital SultanahNurZahirah, Kuala Terengganu, Malaysia; 8Hospital SultanahAminah, Johor Bahru, Malaysia; 9Hospital UniversitiSains Malaysia, Kelantan, Malaysia; 10Hospital TengkuAmpuanAfzan, Kuantan, Malaysia; 11Institute of Respiratory Medicine, Kuala Lumpur, MalaysiaBackground: Budesonide/formoterol used for both maintenance and reliever therapy has been shown to benefit patients with persistent asthma. We evaluated patient satisfaction and asthma control among Malaysian patients prescribed budesonide/formoterol as single maintenance and reliever therapy in a real-life clinical practice.Methods: Adult patients diagnosed with partially controlled or uncontrolled asthma were recruited in a 6-month, prospective, open-label study involving ten hospital-based chest clinics in Malaysia. Patients were prescribed one or two inhalations of budesonide/formoterol Turbuhaler (160/4.5 µg per inhalation) twice daily as maintenance therapy and additional inhalation as reliever therapy. Maintenance doses were decided by physicians based on Global Initiative for Asthma-defined treatment objectives. The primary outcome measure was the change in mean Satisfaction with Asthma Treatment Questionnaire (SATQ) scores from baseline to an average of 3 months and 6 months. Secondary outcome was the change in mean Asthma Control Questionnaire 5-item version (ACQ-5) scores from baseline to an average of 3 months and 6 months and the proportion of patients achieving the minimum clinically important difference.Results: Of 201 eligible patients recruited, 195 completed the study. Overall, SATQ mean (standard deviation) score was significantly improved from 5.1 (0.76) at baseline to 5.5 (0.58) (P < 0.001). The increase was observed in all domains of SATQ and had occurred at 3 months for most patients. ACQ-5 mean (standard deviation) score was significantly reduced from 2.2 (1.13) at baseline to 1.2 (0.95) (P < 0.001). A total of 132 (67.7.1%) patients had achieved the minimal clinically important difference (≥0.5) of ACQ-5 scores at study end.Conclusion: In a nationwide study, budesonide/formoterol maintenance and reliever therapy achieved greater patient satisfaction and better asthma control compared with previous conventional asthma regimes among Malaysian patients treated in a real-life practice setting. Such an approach may represent an important treatment alternative for our local patients with persistent asthma.Keywords: asthma, asthma control, Malaysia, maintenance and reliever therapy, satisfaction, Symbicort, budesonide/formoterol