<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0871-9721</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Imunoalergologia]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Imunoalergologia]]></abbrev-journal-title>
<issn>0871-9721</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Alergologia e Imunologia Clínica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0871-97212023000400271</article-id>
<article-id pub-id-type="doi">10.32932/rpia.2023.12.125</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Qualidade da prescrição de terapêutica de alívio na asma em cuidados de saúde primários]]></article-title>
<article-title xml:lang="en"><![CDATA[Quality of asthma relief therapy prescription in primary health care]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pires]]></surname>
<given-names><![CDATA[João R. Nunes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Leite]]></surname>
<given-names><![CDATA[Raquel Baptista]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moita]]></surname>
<given-names><![CDATA[Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Ana Sofia R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Florova]]></surname>
<given-names><![CDATA[Violeta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Unidade de Saúde Familiar São Martinho de Alcabideche  ]]></institution>
<addr-line><![CDATA[Cascais ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>31</volume>
<numero>4</numero>
<fpage>271</fpage>
<lpage>279</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0871-97212023000400271&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0871-97212023000400271&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0871-97212023000400271&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO A atualização de 2020 da Global Initiative for Asthma (GINA) trouxe mudanças relativamente à gestão farmacológica dos doentes asmáticos, que perduram até à atualidade. Destaca-se a recomendação universal, em indivíduos com idade superior a 12 anos, da utilização de corticosteroide inalado (ICS) como terapêutica de controlo para uma redução do risco de agudizações, bem como a advertência para os riscos inerentes à utilização isolada de agonista beta2 de curta ação de duração (SABA) como terapêutica de alívio, sendo fortemente aconselhada a sua substituição ou associação com ICS desde os estádios mais precoces de doença. Objetivos: Avaliar a qualidade da prescrição de terapêutica de alívio na asma ligeira-moderada numa unidade de cuidados de saúde primários (CSP). Paralelamente, procedeu-se à análise demográfica dos fatores de risco e provas de função respiratória nestes doentes. Métodos: Estudo transversal descritivo que incluiu todos os utentes inscritos com seguimento na unidade de estudo, com idade igual ou superior a 12 anos, codificados com asma como problema ativo e com terapêutica inalatória de alívio prescrita nos dois anos prévios. Resultados: Foram incluídos 271 utentes depois de aplicados os critérios mencionados. A maioria não tinha ICS incluído na terapêutica de alívio (72,5%), estando 87,9% medicados apenas com SABA. Não havia registo de qualquer espirometria em 45,8% dos doentes. Os fatores de risco mais prevalentes eram a rinite alérgica, obesidade e tabagismo. Conclusões: A prescrição de terapêutica de alívio da maioria dos utentes não vai ao encontro das recomendações internacionais atuais, aumentando o risco de agudizações, hospitalizações e mortalidade associadas à asma. Também foi possível aferir a reduzida codificação de asma, a escassa avaliação e/ou reavaliação da função pulmonar com espirometria e a elevada prevalência de fatores de risco modificáveis bem conhecidos, onde a intervenção médica precoce tem um papel preponderante.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT The 2020 update of the Global Initiative for Asthma (GINA) brought some updates regarding the pharmacological management of asthmatic patients. Noteworthy is the recommendation of inhaled corticosteroids (ICS) as a control therapy to reduce the exacerbation risk for ages above 12 years old, as well as the caution about the inherent risk concerning the isolated use of short-acting beta-agonists (SABA) as reliever medication, which should be replaced or associated with ICS from the earliest stages of the disease. Objectives: The aim of this study was to assess the quality of the prescription of reliever medication for mild-to-moderate asthma in a Primary Health Care unit. Simultaneously, the analysis of demographic data, risk factors and pulmonary function tests was carried out for the same sampled population. Methods: Descriptive cross-sectional study of internal evaluation that included all users enrolled in a healthcare unit, aged 12 years old and above, coded with asthma as an active problem and with reliever medication prescribed in the last 2 years. Results: 271 patients were included in the study after applying the above criteria. Most had no ICS included in reliever medication (72.5%), of which 87.9% were prescribed with SABA alone. Almost half (45.8%) had no record of any previous spirometry. The most prevalente risk factors observed were allergic rhinitis, obesity and smoking. Conclusions: The prescription of reliever medication for most users does not meet current international recommendations, increasing the risk of associated exacerbations, hospitalizations and mortality. It was also possible to assess the reduced codification of asthma, the poor assessment and/or reassessment of lung function with spirometry and the high prevalence of well-known modifiable risk factors, in which early medical intervention plays a major role.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Asma]]></kwd>
<kwd lng="pt"><![CDATA[cuidados de saúde primários]]></kwd>
<kwd lng="pt"><![CDATA[função pulmonar]]></kwd>
<kwd lng="pt"><![CDATA[terapêutica]]></kwd>
<kwd lng="en"><![CDATA[Asthma]]></kwd>
<kwd lng="en"><![CDATA[lung function]]></kwd>
<kwd lng="en"><![CDATA[primary health care]]></kwd>
<kwd lng="en"><![CDATA[therapeutics]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<source><![CDATA[Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sá-Sousa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Morais-Almeida]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Azevedo]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Jacinto]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Todo-Bom]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of asthma in Portugal - The Portuguese National Asthma Survey]]></article-title>
<source><![CDATA[Clin Transl Allergy]]></source>
<year>2012</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>15</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<article-title xml:lang=""><![CDATA[Expert panel report III. Guidelines for the diagnosis and management of asthma]]></article-title>
<source><![CDATA[National Asthma Education and Prevention Program]]></source>
<year>2007</year>
<publisher-loc><![CDATA[Bethesda, MD ]]></publisher-loc>
<publisher-name><![CDATA[National Heart, Lung, and Blood Institute]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Suissa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ernst]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>1994</year>
<volume>149</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>604</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lemanske Jr]]></surname>
<given-names><![CDATA[RF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Beta agonists in asthma: Acute administration and prophylactic use]]></article-title>
<source><![CDATA[Uptodate]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is there a problem with inhaled long-acting &#946;-adrenergic agonists?]]></article-title>
<source><![CDATA[J Allergy Clin Immunol]]></source>
<year>2006</year>
<volume>117</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3-16</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Leslie]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Coats]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Salbutamol-induced diabetic ketoacidosis]]></article-title>
<source><![CDATA[Br Med J]]></source>
<year>1977</year>
<volume>2</volume>
<numero>6089</numero>
<issue>6089</issue>
<page-range>768</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[van den Berg]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Louwerse]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypokalaemia in healthy volunteers after single and multiple doses of formoterol or salbutamol]]></article-title>
<source><![CDATA[Clin Drug Investig]]></source>
<year>1998</year>
<volume>15</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>523</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Osuorji]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute stress cardiomyopathy following treatment of status asthmaticus]]></article-title>
<source><![CDATA[South Med J]]></source>
<year>2009</year>
<volume>102</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>301</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[O&#8217;Byrne]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[FitzGerald]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Inhaled combined budesonide-formoterol as needed in mild asthma]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2018</year>
<volume>378</volume>
<page-range>1865-76</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beasley]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Holliday]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Controlled trial of budesonide-formoterol as needed for mild asthma]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2019</year>
<volume>380</volume>
<page-range>2020-30</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moloney]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Digby]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[MacKinnon]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Morra]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barber]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Queenan]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[To]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Lougheed]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Primary care asthma surveillance: a review of knowledge translation tools and strategies for quality improvement]]></article-title>
<source><![CDATA[Allergy Asthma Clin Immunol]]></source>
<year>2023</year>
<volume>19</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fletcher]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tsiligianni]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Kocks]]></surname>
<given-names><![CDATA[JWH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Improving primary care management of asthma: do we know what really works?]]></article-title>
<source><![CDATA[npj Prim. Care Respir Med]]></source>
<year>2020</year>
<volume>30</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>29</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
