{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:43:47Z","timestamp":1785523427990,"version":"3.56.0"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Global Initiative for Asthma (GINA) and National Asthma Education and Prevention Program (NAEPP) both recommend a combination inhaled corticosteroid (ICS)\/formoterol inhaler to replace short\u2010acting beta\u2010agonists (SABA) as the preferred reliever therapy for Steps 3 and 4 of their asthma treatment strategies (known as Single Maintenance and Reliever Therapy or SMART). The extent of adoption and factors influencing use among pediatric asthma specialists remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To gain a better understanding of SMART prescribing practices and factors that facilitate or impede its use in the United States among pediatric asthma specialists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An electronic survey on SMART knowledge and practices was distributed to pediatric pulmonology division directors for dissemination to pediatric asthma specialists in allergy and pulmonology divisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010eight completed survey responses were received between March and October of 2024. All asthma specialists were familiar with SMART, and over 90% were comfortable with its implementation in pediatric asthma. However, there was wide variability in the percentage of patients advised to use their prescribed maintenance ICS\/formoterol inhaler as a reliever that did not correlate with the comfort level of the clinician or years in clinical practice, but did correlate with the region of practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite GINA\/NAEPP recommending SMART, there is substantial variation in its implementation among pediatric asthma specialists. Survey results indicate that pediatric asthma specialists are comfortable with its use, but that improvement in EMR efficiency and consistent insurance coverage are needed to increase SMART adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71427","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:24:38Z","timestamp":1765261478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Barriers to Implementation of SMART: Views From Pediatric Asthma Specialists"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1701-4585","authenticated-orcid":false,"given":"John Paul","family":"Jarczyk","sequence":"first","affiliation":[{"name":"The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne J.","family":"Morgan","sequence":"additional","affiliation":[{"name":"The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"P.O'Byrne E. D.Bateman J.Bousquet et al. Global Strategy for Asthma Management and Prevention 2006 https:\/\/ginasthma.org\/wp-content\/uploads\/2019\/01\/2006-GINA.pdf."},{"key":"e_1_2_11_3_1","unstructured":"Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2019 accessed September 14 2024 https:\/\/ginasthma.org\/wp-content\/uploads\/2019\/06\/GINA-2019-main-report-June-2019-wms.pdf."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202109-2205pp"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.10.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01688-2017"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26647"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/aci.0000000000000518"},{"key":"e_1_2_11_9_1","unstructured":"United States Department of Health and Human Services. Centers for Disease Control and Prevention. \u201cMost Recent National Asthma Data.\u201d Centers for Disease Control and Prevention 5 January 2025 https:\/\/www.cdc.gov\/asthma\/most_recent_national_asthma_data.htm#print."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/mcp.0000000000000862"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.05.023"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jac5.1922"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2024.06.011"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.10.027"},{"key":"e_1_2_11_15_1","unstructured":"American Lung Association.Cost Analysis of SMART Therapy to Improve Asthma Outcomes https:\/\/www.lung.org\/blog\/asthma-smart-therapy."}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71427","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71427","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71427","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T15:00:33Z","timestamp":1771426833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ppul.71427"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71427","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71427"}}