Abstract

Background
Uncontrolled asthma can lead to frequent exacerbations with increased use of inhaled SABA leading to avoidable hospitalisations. Also resulting in use of oral corticosteroids which are associated with a plethora of side effects.
.. There is an opportunity to identify initiatives across the PCN to improve overall asthma care

Aim
. Improve asthma care across the PCN by reducing SABA overuse, oral corticosteroids, and increased referral to severe asthma clinic.
Method
• Develop PCN based Diagnostic Hub for accurate diagnosis of asthma.
• Education for HCP’s regarding use of oral steroids and strategies to reduce exacerbations.
• Prioritise a single ICS/LABA inhaler approach (Track 1 GINA guidelines) in the management of our asthma population. Patients were identified for change at asthma review and on presenting with worsening asthma symptoms.
• Targeted intervention for high-risk patients (2 or more OCS and 6 SABA per year) and reviewed using NSHI therapy review service REACT funded by Chiesi
• Further audit identified any patient who continued to exacerbate who were then reviewed by specialist respiratory ACP’s from the PCN
• Template to facilitate medication change at the point of exacerbation and initiated patients on ICS/formoterol containing therapies as per GINA track 1
• Education regarding Severe Asthma. Template developed working with the local Severe Asthma Clinic which facilitated referrals to ensure all relevant information was provided on referral.
Results
• 24% reduction in patients having 2 more courses OCS
• 20% reduction in patients using 12 or more SABA
• 40% increase in referrals to severe asthma clinic
• 35% Reduction in inhaler carbon emissions achieving upper 5th percentile across ICB in this measure
Conclusion
A reduction in overall asthma risk can be achieved by changes to patient diagnosis process, HCP education, inhaler formulary and clinical templates.