Improving asthma outcomes by following guideline directed care with SENTINEL Plus in the Armagh/Dungannon Federation (ID 614)
Armagh and Dungannon GP Federation1. AstraZeneca, Medical and Scientific Affairs, Biopharmaceuticals Medical, London, United Kingdom2
Abstract
Introduction
In 2023, the respiratory index data from Asthma and Lung UK ranked Armagh Banbridge Craigavon council area as 208 of 217 in terms of highest respiratory rate of deaths and emergency admissions2. Short Acting Beta Agonist (SABA) only reliever over use continues to negatively impact asthma patient outcomes. The Armagh/Dungannon Federation worked collaboratively with AstraZeneca utilising SENTINEL plus1, a co-designed quality improvement package, in conjunction with Interface Clinical Services to improve asthma patient outcomes.
Aim
Improve asthma patient outcomes by identifying SABA only reliever overuse, holistically review asthma patients and commence guideline directed Maintenance and Reliever Therapy (MART) in appropriate patients.
Methods
From June 2024 to March 2025 Interface Clinical Services analysed routinely collected NHS data to form a baseline report and conducted targeted asthma reviews aligned with SENTINEL Plus in 16 GP practices within Armagh and Dungannon Federation. This was coupled with asthma management educational sessions and access to the SENTINEL Plus website resource being made available.
Results
920 patient reviews were undertaken.
• 660 (72%) patients had their SABA-only or short acting muscarinic antagonist (SAMA) stopped
• 740 (80%) patients in total are on a MART regime (668 new initiations).
• 56 out of 107 (52%) patients who smoke expressed wanting to stop smoking and were signposted/referred for smoking cessation service.
• 917 (99%) patients had their inhaler checked
Conclusion
The Joint working between the Federation and AstraZeneca resulted in improved asthma guideline directed care. SABA-only reliever prescribing was reduced, and MART uptake increased. An approach, which in November 2024, was consolidated with the update of BTS, NICE, SIGN3 joint asthma guideline.
References
1. Crowther L, Pearson M, Cummings H, Crooks MG. Towards codesign in respiratory care. BMJ Open Respir Res. 2022;9(1):e001155.
2. Asthma & Lung UK. Respiratory Index. https://public.tableau.com/app/profile/asthmaandlunguk/viz/Respiratoryindexvisualisations/Respiratoryindex. Accessed April 2025.
3. NICE, BTS, SIGN. Asthma: diagnosis, monitoring and chronic asthma management.2024. https://www.nice.org.uk/guidance/ng245. Accessed 10 Apr 2025.
Funding: The project was funded and delivered via equal contribution from NHS and AZ as part of a Joint Working Agreement.
Conflicts of interest: None
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