Sandra Zaeh, MD

Funded by The Jeanette Casano Catalyst Award

Asthma is a major cause of chronic lung disease for adults in the United States, affecting over 20 million people. Use of a single inhaler for daily asthma maintenance and relief Single Maintenance and Reliever Therapy (SMART) when patients are having worsening symptoms significantly reduces asthma exacerbations and improves asthma medication adherence. While use of SMART is now incorporated into national asthma guidelines, it is not widely used in the clinical setting, in part due to patient-related factors. Our preliminary data shows that pulmonologists prescribe SMART infrequently as they are concerned patients do not know how to use it or are unwilling to transition their inhaler regimen to SMART. We will identify patient self-management supports needed to use SMART. This information will allow us to develop and pilot a mobile health education and self-management intervention for adults with asthma that is acceptable and feasible, promoting clinician and patient adoption of SMART.

Update:

We conducted an analysis of electronic medical records between January 2021 and October 2023 to assess the number of patients with moderate to severe asthma who were prescribed SMART, in accordance with national asthma guidelines. Only 14.5% of patients with moderate to severe asthma were prescribed SMART, with 87% of patients being concurrently prescribed albuterol, potentially limiting the efficacy of SMART. We also found limited adoption of SMART by clinicians, with over 40% not prescribing SMART. Our data suggests there has been limited implementation of SMART to date with a small number of clinicians adopting SMART routinely.