In this study, 303 adult asthma patients (44 of whom were Māori) were randomised to the single combination budesonide/formoterol inhaler as maintenance and reliever therapy (‘SMART’) regimen or ‘standard’ regimen (combination budesonide/formoterol inhaler for maintenance and salbutamol as reliever) for 24 weeks. In analyses adjusting for ethnicity, the SMART regimen was associated with fewer days of ‘high use’ of reliever therapy (defined as >8 actuations of budesonide/formoterol in excess of 4 maintenance doses per day for SMART and >16 actuations per day of salbutamol for standard) (relative rate [RR] 0.57; 95% CI, 0.38 to 0.85), fewer days of high use without medical review within 48 h (RR 0.49; 95% CI, 0.32 to 0.75) and fewer severe exacerbations (RR 0.54; 95% CI, 0.36 to 0.81) compared with the standard regimen. The magnitude of the benefit from the SMART regimen was similar in Māori and non-Māori. Days of high use, days of high use without medical review and underuse of maintenance treatment were greater in Māori, regardless of treatment regimen.
