Abstract

Background and Objectives:
Poor asthma control leads to high symptom burden, impaired quality of life, and frequent exacerbations. Effective self-management requires patient understanding and empowerment, yet there is limited provision of patient-centred asthma education in the UK. ESMENA, a multidisciplinary team intervention, was developed to provide comprehensive education for patients with poorly controlled asthma, aiming to improve asthma control and self-management skills.

Methods:
Adults referred to the asthma clinic with persistent poor control despite moderate/high-dose ICS and additional controller therapy were invited to participate in ESMENA. The programme consisted of a 4-hour face-to-face session covering asthma science, treatments, inhaler technique, comorbidities, and personalised action plans. Participants had access to an online portal with summary videos. Asthma control, healthcare utilisation, quality of life, lung function, and T2 biomarkers were measured at baseline, 6, and 12 months. Patient feedback and confidence measures were also collected.

Results:
57 patients attended ESMENA sessions between May-November 2022, with 51 completing 12-month follow-up. The cohort had a mean age of 57.7 years (SD 13.2), was predominantly female (78%), and mean BMI of 30.4 (SD 6.4). At baseline, 61% were on high-dose ICS. Thirteen patients (25%) escalated to biologic therapy during follow-up. Significant improvements were observed in asthma control, quality of life, exacerbation frequency, emergency department attendances, and hospital admissions (Table 1). T2 biomarkers also improved significantly. Patient feedback was positive, with improved confidence in understanding treatments and self-managing symptoms.

Conclusions:
ESMENA demonstrated the value of a comprehensive asthma education programme delivered as part of routine clinical care. The intervention facilitated rapid access to biologic therapy for 25% of patients, while significant benefits were observed in the remaining 75% without further treatment escalation (Table 1). Empowering patients with knowledge about their condition reduces the burden on emergency care providers and improves overall asthma management and patient confidence.