Improving asthma care through implementation of the SENTINEL programme: findings from the pilot site.
ERJ Open Res
; 9(3)2023 May.
Article
em En
| MEDLINE
| ID: mdl-37228273
ABSTRACT
Aim:
Short-acting ß2-agonist (SABA) overuse adversely impacts asthma-related outcomes and the environment. The SABA rEductioN Through ImplemeNting Hull asthma guidELines (SENTINEL) programme aims to reduce SABA overuse through supported implementation of an adult asthma guideline, which advocates for a SABA-free maintenance and reliever therapy (MART)-preferred treatment where appropriate, across six primary care networks (PCNs) in the UK. We present findings on patient/disease characteristics, asthma prescribing patterns and exacerbation rates from the pilot PCN.Methods:
Patients (aged ≥18â years, prescribed at least one inhaled therapy) and their prescribed asthma treatments were characterised using National Health Service data. Asthma treatments and exacerbations were analysed for three periods 24â12â months pre-, 12â months pre- and 12â months post-SENTINEL implementation (November 2020âJanuary 2021).Results:
Of the 2571 registered asthma patients, 33.6% (n=864) underwent an asthma review, of whom 44.7% (n=386) were transitioned to MART. Fewer patients were prescribed three or more SABA canisters per year post-implementation in the overall asthma population (45.4% and 46.2% during 24â12â months and 12â months pre-implementation, respectively, and 23.9% 12â months post-implementation), and in the two subgroups 1) those who had an asthma review (74.5% and 83.6% during 24â12â months and 12â months pre-implementation, respectively, and 26.5% post-implementation); and 2) those transitioned to MART following a review (76.4% and 86.5% during 24â12â months and 12â months pre-implementation, respectively, and 16.3% post-implementation). A higher proportion of patients were exacerbation-free post-implementation in the overall asthma population and in the two subgroups. At least 71.5% of patients transitioned to MART were still prescribed MART 12â months post-implementation, of whom ≥86.7% were SABA-free.Conclusion:
SENTINEL implementation led to reduced SABA prescribing, increased inhaled corticosteroid uptake and fewer asthma exacerbations. MART was considered appropriate for â¼50% of reviewed patients, with improved prescribing patterns sustained post-implementation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Sysrev_observational_studies
Idioma:
En
Revista:
ERJ Open Res
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Reino Unido