Improving asthma outcomes in Lancashire and South Cumbria (L&SC) through SABA reduction and MART implementation with SENTINEL Plus. (ID 677)
AstraZeneca
Abstract
Introduction
There has been a concern nationally regarding the over-reliance on SABA -only reliever among asthma patients which can lead to poor asthma control, increased risk of exacerbations, and potential long-term consequences including avoidable excess carbon footprint.
Strategy for change
L&SC ICB joint working with AstraZeneca using SENTINEL Plus, a quality improvement programme that aims to improve asthma management in patients, identifying and addressing Short-acting Beta-2 Agonist (SABA) over-use and implementing Maintenance and Reliever Therapy (MART).
Methods
From October 2023 to September 2024, Interface Pharmacy Services analysed routinely collected NHS data to form a baseline and conducted asthma reviews aligned with SENTINEL Plus in 20 practices where 14,590 asthma patients are registered. Clinicians were provided with educational sessions on asthma management to adopt sustainable implementation of the national guidance. Changes in prescribing practice were reported using descriptive statistics.
Results
1,048 patient reviews were undertaken.
• 598 (57.1%) patients had their short acting bronchodilator SABA-only or short acting muscarinic antagonist (SAMA) stopped
• 753 (71.9%) patients commenced on MART
• 932 (88.9%) reviewed patients received advice on worsening asthma control and provision of a personalised asthma action plan
• 89 patients out of 170 (52.3%) patients who smoke expressed wanting to stop smoking and were signposted/referred for smoking cessation service.
• 1,039 (99%) patients had their inhaler checked
Conclusion
The Lancashire and South Cumbria ICB joint working approach created a collaborative framework to encourage an interdisciplinary approach and foster partnerships across multiple stakeholders in the ICB.
This resulted in a reduction in SABA-only prescribing, and an increase in MART. Implementing guideline recommended therapy is critical to improve outcomes and to support decarbonising healthcare delivery.
References
1. Crowther L, Pearson M, Cummings H, Crooks MG. Towards codesign in respiratory care: development of an implementation-ready intervention to improve guideline-adherent adult asthma care across primary and secondary care setting. BMJ Open Respiratory Research. 2022 Feb 1;9(1): e001155.
2. Wilkinson AJK, Maslova E, Janson C, Radhakrishnan V, Quint JK, Budgen N, Tran TN, Xu Y, Menzies-Gow A, Bell JP. Greenhouse gas emissions associated with suboptimal asthma care in the UK: Thorax. 2024 Feb 27;79(5):412–21
Funding: This was a joint working collaborative with AstraZeneca Lancashire and South Cumbria ICB,
Conflicts of interest: AstraZeneca employees (2) and NHS employees (1)
Preston M 1, Beaumont-Kellner H 2, O’Reilly-Smyth A 2, Lawson J 1, Rooney M 2
1: Medicines Optimisation (Fylde Coast), NHS Lancashire and South Cumbria Integrated Care Board
2: AstraZeneca, Medical and Scientific Affairs, Biopharmaceuticals Medical, London, United Kingdom
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