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Stepped treatment algorithm using budesonide-formoterol for chronic respiratory diseases: A single arm interventional
Wan-Chun Huang1,2,3, Greg J Fox4, Ngoc Yen Pham1
1Woolcock Institute of Medical Research, Hanoi, Vietnam.
Plos One
|July 11, 2022
Summary
A stepped treatment algorithm using inhaled budesonide-formoterol is feasible for managing chronic respiratory diseases in rural Vietnam. This approach demonstrated adherence and manageable daily dosage for patients needing respiratory symptom relief.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Trials
Background:
- Inhaled budesonide-formoterol is established for asthma symptom relief.
- Its use in undifferentiated chronic respiratory diseases in rural settings is not well-studied.
- This study addresses the feasibility gap in resource-limited areas.
Purpose of the Study:
- To assess the feasibility of a stepped treatment algorithm using inhaled budesonide-formoterol.
- To evaluate this pragmatic intervention in patients with chronic respiratory diseases in rural Vietnam.
- To establish a novel therapeutic approach for underserved populations.
Main Methods:
- A pragmatic, stepped algorithm intervention was implemented in three rural hospitals in Hanoi, Vietnam.
- Patients with airflow obstruction or asthma-consistent symptoms were recruited.
- The algorithm involved as-needed budesonide-formoterol, escalating to maintenance plus as-needed therapy, or referral, over 12 months.
Main Results:
- 313 participants initiated the algorithm, with 47.2% experiencing acute respiratory symptoms and 35.4% diagnosed with exacerbations.
- After 12 months, 50.7% adhered to the recommended treatment step.
- Average daily budesonide-formoterol use was low, with only 3.8% exceeding 800μg/day.
Conclusions:
- The novel stepped therapeutic algorithm is feasible for managing chronic respiratory diseases in rural Vietnam.
- This approach offers a potential solution for symptom management in resource-limited settings.
- Further research is needed to confirm effectiveness, safety, and cost-effectiveness.
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