Abstract

Introduction: Asthma biologics can be lifechanging for patients with severe asthma. Yet, identification of potential patients for treatment in primary-care is often deficient1.

Derbyshire has the highest population-adjusted uptake of biologics across the Midlands. Part of this success may be attributed to the Improving Adult respiratory Care Together (ImpACT+) team, an integrated care service providing holistic support for patients with lung diseases2. This includes virtual multidisciplinary team (MDT) discussion between primary-care teams and respiratory clinicians regarding complex cases.

We evaluated the role of ImpACT+ in identifying and supporting patients newly started on asthma biologics.

Methods: Data were retrospectively reviewed for patients on biologics at the Royal Derby Hospital between January 2018-2023. The number of ImpACT+ referrals, services accessed, and dates of biologic initiation were recorded. The time to starting treatment from ImpACT+ MDT discussion was compared against published national waiting times3. Data are presented as mean(SD), median(IQR), or n(%).

Results: 247 patients [age: 55(14) years, n male/female: 89/158] received biologics. There were 245 ImpACT+ referrals, with 124(50%) patients requiring at least one referral. Services accessed are outlined in Figure 1. 33 patients were discussed in the MDT (28 before biologics). The time to treatment was 439(325-627) days, which is shorter than previously published data (63.5 weeks from primary-care referral to starting biologics).

Conclusion: The ImpACT+ team enabled patients with asthma to access a range of specialist services prior to and following biologics initiation. Furthermore, referral to the ImpACT+ MDT facilitated access to severe asthma care and biologic pharmacotherapy.

Reference:
1. Management of Uncontrolled Asthma in Adults, 2022 (https://www.healthinnovationoxford.org/wp-content/uploads/2022/06/AAC-Pathway-16.9_FINAL-No-NHS.pdf)
2. Subramanian D, et al. P170 Reducing non-elective respiratory admissions: initial experience of the derby integrated ImpACT+ respiratory service.Thorax 2019;74:A182
3. Rupani H, et al. P145 What is the severe asthma patient journey to biologic initiation in UK severe asthma centres?Thorax 2022;77:A159-A160.