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Improving asthma care through implementation of the SENTINEL programme: findings from the pilot site

Crooks, Michael G.; Crowther, Lucia; Cummings, Helena; Cohen, Judith; Huang, Chao; Pitel, Lukas; Pearson, Mark; Morice, Alyn; Turgoose, John; Faruqi, Shoaib; Watt, Michael; Morris, Tamsin; Xu, Yang

Authors

Lucia Crowther

Helena Cummings

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Mr John Turgoose J.Turgoose@hull.ac.uk
Information Systems Manager - Hull Health Trials Unit

Shoaib Faruqi

Michael Watt

Tamsin Morris

Yang Xu



Abstract

Aim: Short-acting β2-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 ⩾18 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: 24‒12 months pre-, 12 months pre-and 12 months post-SENTINEL implementation (November 2020‒January 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 24‒12 months and 12 months pre-implementation, respectively, and 23.9% 12 months post-implementation), and in the two subgroups: 1) those who had an asthma review (74.5% and 83.6% during 24‒12 months and 12 months pre-implementation, respectively, and 26.5% post-implementation); and 2) those transitioned to MART following a review (76.4% and 86.5% during 24‒12 months and 12 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 12 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 ∼50% of reviewed patients, with improved prescribing patterns sustained post-implementation.

Citation

Crooks, M. G., Crowther, L., Cummings, H., Cohen, J., Huang, C., Pitel, L., …Xu, Y. (2023). Improving asthma care through implementation of the SENTINEL programme: findings from the pilot site. ERJ Open Research, 9(3), Article 00685-2022. https://doi.org/10.1183/23120541.00685-2022

Journal Article Type Article
Acceptance Date Feb 12, 2023
Online Publication Date May 9, 2023
Publication Date May 1, 2023
Deposit Date Jan 20, 2024
Publicly Available Date Jan 25, 2024
Journal ERJ Open Research
Electronic ISSN 2312-0541
Publisher European Respiratory Society
Peer Reviewed Peer Reviewed
Volume 9
Issue 3
Article Number 00685-2022
DOI https://doi.org/10.1183/23120541.00685-2022
Public URL https://hull-repository.worktribe.com/output/4403057

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