• J Am Board Fam Med · Jul 2024

    Review

    Be SMART About Asthma Management: Single Maintenance and Reliever Therapy.

    • Alexander F Infante, Christina Wells, Julie Loza, Keia Hobbs, Jennie B Jarrett, and Abigail T Elmes.
    • From the University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (AFI); University of Illinois College of Medicine at Chicago, Chicago, Illinois (CW); University of Illinois College of Medicine at Chicago, Chicago, Illinois (JL); University of Illinois College of Medicine at Chicago, Chicago, Illinois (KH); University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (JBJ); University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (ATE).
    • J Am Board Fam Med. 2024 Jul 1; 37 (4): 745752745-752.

    AbstractSingle 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).© Copyright by the American Board of Family Medicine.

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