GINA step 4 and 5 single inhaler triple therapy (SITT) management in European asthma patients: EU-LAMA survey.

<bold>Background:</bold> Triple therapy (long acting beta-2 agonist; LABA+long acting muscarinic antagonist; LAMA+ inhaled corticosteroids; ICS) is widely recommended in asthma treatment,but little is known about physicians’ opinions and behaviours in a real-life setting. <bold>Aims and objectives:</bold> The objective of this study was to assess physicians' perceptions of the intensification of treatment regimes in not well-controlled asthma including ICS,LABA,LAMA,biologics,and oral corticosteroids(OCS). <bold>Methods:</bold> A 19-question survey was distributed in Poland, Greece, Sweden, Slovenia, Austria on the CATI-system platform (http://www.cati-system.pl/) using an electronic CAWI(Computer Assisted Web Interviews) method. Pulmonologists,allergologists,general practitioners, internal medicine specialists were invited. <bold>Results:</bold>630 surveys were completed in Poland(57.6%), Greece(27%), Sweden(6.3%), Slovenia (5.4%), and Austria(3.7%). The question: Do you use triple therapy (ICS+LABA+LAMA) in asthma management?’ was positively responded to by 92% of physicians in Poland,97% in Greece,65% in Sweden,100% in Slovenia,87% in Austria (p<0.001). Questions also referred to various combinations (three separate inhalers, two separate inhalers, or single inhaler triple therapy; SITT), which may impact adherence and treatment effectiveness. On the question:” Do you use SITT in asthma patients at GINA step 4 or step 5?’ was positively responded to by 72%/83% in Poland, 71%/86% in Greece, 69%/77% in Sweden, 59%/59% in Slovenia, 65%/80% in Austria. <bold>Conclusions:</bold> The majority of the responding physicians use triple therapy in asthma management but 28-41% of patients at step 4 and 15-41% at step 5 still remain without SITT.