Background The overuse of short-acting β2-agonists (SABA) is associated with poor asthma control. However, data on SABA use in the Gulf region are limited. Herein, we describe SABA prescription practices and clinical outcomes in patients with asthma from the Gulf cohort of the SABA use IN Asthma (SABINA) III study. Methods In this cross-sectional study conducted at 16 sites across Kuwait, Oman, and the United Arab Emirates, eligible patients (aged ≥ 12 years) with asthma were classified based on investigator-defined disease severity guided by the 2017 Global Initiative for Asthma report and by practice type, i.e., respiratory specialist or primary care physician. Data on demographics, disease characteristics, and prescribed asthma treatments, including SABA, in the 12 months prior to a single, prospective, study visit were transcribed onto electronic case report forms (eCRFs). All analyses were descriptive in nature. Continuous variables were summarized by the number of non-missing values, given as mean (standard deviation [SD]) and median (range). Categorical variables were summarized by frequency counts and percentages. Results This study analyzed data from 301 patients with asthma, 54.5% of whom were treated by respiratory specialists. Most patients were female (61.8%), with a mean age of 43.9 years, and 84.4% were classified with moderate-to-severe disease, with a mean (SD) asthma duration of 14.8 (10.8) years. Asthma was partly controlled or uncontrolled in 51.2% of patients, with 41.9% experiencing ≥ 1 severe exacerbation in the 12 months preceding their study visit. Overall, 58.5% of patients were prescribed ≥ 3 SABA canisters, 19.3% were prescribed ≥ 10 canisters, and 13.3% purchased SABA over-the-counter (OTC) in the 12 months before the study visit. Most patients who purchased OTC SABA (92.5%) also received SABA prescriptions. Inhaled corticosteroid/long-acting β2-agonist combinations and oral corticosteroid bursts were prescribed to 87.7% and 22.6% of patients, respectively. Conclusions SABA over-prescription was highly prevalent in the Gulf region, compounded by purchases of nonprescription SABA and suboptimal asthma-related outcomes. Increased awareness among policymakers and healthcare practitioners is needed to ensure implementation of current, evidence-based, treatment recommendations to optimize asthma management in this region. Trial registration NCT03857178 (ClinicalTrials.gov).

Distress, including anxiety and depression, is an important psychological adjustment measure in a stressful work setting such as the oil production industry. Among the factors that can influence psychological distress are demographic and work-related conditions. The objective of the present study was to explore anxiety and depression among oil workers, and examine the relationships with sociodemographic characteristics and work-related factors. A cross-sectional study was conducted on a sample of 2123 workers selected by a stratified random sampling scheme from 10 oil companies in Kuwait. The workers were invited to complete a self-administered questionnaire including sociodemographic characteristics, work-related factors, and psychological aspects. Anxiety and depression were assessed by the Hopkins symptom checklist-25 scale. A hierarchical multiple regression procedure was used to assess the association of psychological distress with demographic and work-related factors. The multiple linear regression analysis ascertained the significant relationship of psychological distress with gender, age, nationality, marital status, education, satisfaction with job, and shift work after controlling the variance accounted by all demographic and work related variables. Demographic variables explained 22.5% of the variation in total distress. Dissatisfaction with job explained an additional 10.7% of the variation in total distress, while shift work explained an additional 15.5% of the variation in total distress. All included variables explained 48.7% of the variation in total distress. Sociodemographic and workrelated variables are associated with psychological distress. Controlling workers' demographic correlates, and adjusting working conditions might reduce the levels of anxiety and depression among oil workers.

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