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 Mahayiddin<sup>11

1</sup>Department 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, Malaysia

Background: 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