When prescribing SMART regimen for a new diagnosis of asthma, do you still prescribe rescue inhaler (i.e. SABA) if they don't have it?

When using the SMART (single maintenance and reliever therapy), I don't add an albuterol (SABA) rescue inhaler. The whole idea is to simplify things for the patient so that they maintain their asthma control and get relief with the necessary via just one inhaler. Budesonide - formoterol combinations are the most commonly used, so you get anti-inflammation from the glucocorticoid budesonide, and rapid onset bronchodilatation from the beta2-specific agonist formoterol. This regimen has been shown to reduce the frequency of exacerbations with up to 12 puffs daily from the combination inhaler compared to standard maintenance treatment with as-needed albuterol. Hence, both the GINA and NAEPP guidelines have advocated the SMART approach. Another ...

When prescribing a SMART regimen for a newly diagnosed asthma patient, I will sometimes prescribe albuterol/budesonide, but I tend not to prescribe albuterol alone as rescue.