A toolkit to support identification and prioritisation of at-risk asthma and COPD patients (ID 286)
Keele University
Funding: The development of the Toolkit and its delivery was sponsored by GlaxoSmithKline.
Abstract
Background: NRAD (1) and the National COPD Audit (2) identified avoidable risk factors for patients with asthma and COPD. Corresponding recommendations to reduce preventable attacks and improve disease control have been made, but translating these recommendations into practice remains challenging.Objective: Develop a suite of search reports and alert protocols to identify and stratify at-risk patients who would most benefit from a review without contributing unduly to practice workload burden.
Method: Representatives from primary and secondary care agreed a shortlist of ten risk factors considered to be clinically important and implementable in primary care, including: patients with no review in the last 12 months, high use of short-acting reliever inhalers, exacerbations/emergency admissions and no subsequent review, and oral corticosteroid/antibiotic use. Each factor was translated into a series of aggregated EMIS Web search reports and protocol alerts using SNOMED CT coding and consolidated into a single toolkit. The toolkit was beta-tested and validated by clinical pharmacists over a period of three months across practices in the West Midlands to ensure accuracy and utility. In July 2020, the tested version of the toolkit was made available to all healthcare practitioners in the UK – free to download via https://asthmacopdtoolkit.org/.
Results: Since launch, the EMIS Web version of the toolkit has been downloaded 251 times (30 June 2021) and the website visited over 2,750 times. A SystmOne version was launched in October 2020.
Conclusion: Beta-testing concluded the toolkit was easy to install and run and accurately identified ‘at risk’ patients. Plans are currently underway to audit a number of outcomes associated with improvements in respiratory care in a cohort of patients identified using the toolkit.
References:
1. RCP. Why asthma still kills: National Review of Asthma Deaths. 2014.
2. RCP. Planning for every breath. National COPD Audit Programme. 2015–17.
Conflicts of interest: Prescribing Decision Support is a Keele University spin-out. It receives pharmaceutical industry funding to develop digital healthcare platforms such as clinical decision support and audit tools. Authors were remunerated for their time in designing, developing and testing the Toolkit.
The development of the Toolkit and its delivery was sponsored by GlaxoSmithKline.
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