ArticleFrontiers in medicine2026
Assessing the impact of GINA guideline-Concordant medication prescribing on asthma outcomes in a tertiary hospital in Saudi Arabia: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Historically, short-acting β2-agonists (SABAs) have been the preferred reliever therapy for asthma. However, their excessive use is associated with poor treatment outcomes, prompting the recent Global Initiative for Asthma (GINA) guidelines to recommend inhaled corticosteroid (ICS)-formoterol as the preferred reliever. Objectives: This study aimed to assess prescribing patterns of ICS-formoterol and SABAs in asthma patients and to evaluate their impact on clinical outcomes, including exacerbation rates. Methods: This retrospective cohort study included adult asthma patients (≥18 years) treated at a tertiary hospital in the Eastern Province of Saudi Arabia between July 2022 and July 2023. The primary endpoint was the proportion of patients prescribed either Track 1 (ICS-formoterol) or Track 2 (SABA-based) regimens. The secondary endpoints included asthma exacerbations, oral corticosteroid (OCS) use, and treatment step-ups. Results: Of the 405 patients included, the mean age (±SD) was 47.8 years (± 16.8) for Track 1 and 51.5 (±15.3) for Track 2. Only 24.4% of the patients were prescribed Track 1 regimens, while 75.6% followed Track 2. Statistically significant differences were observed in the secondary endpoint for asthma exacerbation with an adjusted odds ratio (aOR) of 3.8 (95% CI: 1.12-13.2, Conclusion: Despite guideline recommendations, SABA-based therapy remains predominant in Saudi Arabia and is associated with higher exacerbation rates compared with ICS-formoterol. Knowledge gaps and the complexity of guidelines may contribute to non-adherence. Targeted interventions are needed to align clinical practice with evidence-based recommendations and improve asthma outcomes.
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