Reducing Short Acting Beta-2 agonist (SABA) inhaler overuse in Asthma using a population health management (PHM) approach and digital intelligence (ID 572)
Dorset ICS
Abstract
Background
Higher SABA use in asthma is associated with poorer outcomes, with 4 or more SABAs a year indicating poor disease control, yet, across England, almost 1 in 5 patients receive >6 SABA per year.
In Weymouth and Portland (W&P) primary care network (PCN) in Dorset, 17% (varying between 8-23% per surgery) of patients with asthma were prescribed >6SABA inhalers in 2022 across 6 practices, with 5% having >12SABA.
The Dorset Intelligence and Insight Service (DiiS) is a database created by Dorset Integrated Care System (ICS) to support a PHM approach to chronic disease management. The database displays pseudonymised data, updated daily, on around 59, 000 patients with asthma and can be viewed at ICS, PCN, GP practice and individual patient level.
Aim
To reduce SABA prescriptions for patients with asthma across W&P PCN.
Methods
DiiS searches were performed for W&P patients with an asthma diagnosis and >12SABA prescriptions in the preceding 12 months.
Several interventions were implemented across the PCN over 15 months including: local pharmacy engagement, staff and patient education including specialist clinical review, FeNO assessment, adoption of MART, creation of a SABA explanatory video, and flagging of patients with monthly SABA repeats.
Results
At one practice which had the highest initial SABA prescribing, the proportion of patients using >12SABA reduced over 15 months by almost 10%, from 11.2% to 1.5% and those using >6 fell by almost 17%, from 25.4% to 8.7%.
There were smaller SABA reductions in the remaining five surgeries, at an overall reduction in >12SABA from 5.2% to 2.4% and a reduction in >6SABA from 16.8% to 12.1%% across the PCN.
Conclusion
A population-based approach informed by data enabled identification of patients with uncontrolled Asthma across the local community. A population-based, data-driven, partnership approach supports reductions in SABA prescribing.
Funding: None
Conflicts of interest: The work was supported by the PCRS with involvement from Jane Watson and Katherine Hickman
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