RT Journal Article
SR Electronic
T1 Be SMART About Asthma Management: Single Maintenance and Reliever Therapy
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 745
OP 752
DO 10.3122/jabfm.2023.230456R1
VO 37
IS 4
A1 Infante, Alexander F.
A1 Wells, Christina
A1 Loza, Julie
A1 Hobbs, Keia
A1 Jarrett, Jennie B.
A1 Elmes, Abigail T.
YR 2024
UL http://www.jabfm.org/content/37/4/745.abstract
AB Single maintenance and reliever therapy (SMART) is an asthma treatment approach that utilizes combined inhaled corticosteroids and long-acting β-agonists for maintenance and quick relief therapy. Despite the evidence for its benefits in asthma treatment and its adoption into American and international asthma guidelines and recommendations, SMART remains a practice of some debate. This article reviews the available evidence for SMART and offers guidance for its integration into comprehensive asthma management. Overall, short-acting β-agonist-only asthma therapy regimens should be avoided, regardless of condition severity (SOR A Recommendation). Family medicine clinicians should start SMART for patients requiring either GINA Step 3 or 4 therapy, especially if they have signs of poor adherence (SOR B Recommendation). Finally, use budesonide-formoterol over other inhaled corticosteroid/long-acting β-agonist combinations when implementing SMART (SOR B Recommendation).