Asthma Interface Nurse Role: A case study example (ID 461)
Hywel Dda University Health Board
Funding: None
Abstract
Asthma UK (2021) state that the standard time from primary care referral to commencing on biological therapy is approximately 1 year. A large-scale U.K. cohort study (208,557 patients) found that 72% of potentially severe asthma patients were not referred in for a specialist respiratory review (Ryan et al., 2021). Therefore, delaying access to biologics, but more importantly continued poor asthma control.The Asthma Interface Nurse Specialist (AINS) role allows working within primary care in order to achieve early identification and rapid access to severe asthma clinic in secondary care. Here is a case study example signposting the efficacy of the service within Hywel Dda University Health Board.
Patients are identified by running searches on the primary care system to run the high short-acting beta 2 agonist (saba) list.
In May 14th, 2022
Patient was identified on the high saba list picking up 12 in 12 months. At a glance, she was on the COPD register.
• AIN booked Pat into clinic for initial review and assessment.
• Diagnosis was also reviewed; therefore spirometry with reversibility and FENO performed. FBC checked.
• Patient findings- Exacerbation rate requiring prednisolone of 6 in 12 months, high symptom burden (ACT 8/20; mini AQLQ 2.3)
• Fev1 1.05l, FENO 61 ppb.
• Eosinophils 2.0
• Result- Referred into DAC.
By September 6th, 2022
Patient had been reviewed by respiratory consultant and discussed at MDT for biologic therapy in line with phenotype.
Pat’s case today:
• no exacerbations since starting biologics
• ACT 25/25
• mini AQLQ 7
• FEV1 1.94 l (850 ml improvement)
• Improved QoL
Conclusion
• Rapid access to biologic therapy – achieved within 4 months of identification
• 3 times faster than the average time found by Asthma UK (2021)
• Resulted in successful business case for more AIN
Conflicts of interest: None
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