Reducing short-acting beta-agonist use in asthma: Impact of national incentives on prescribing practices in England and the findings from SENTINEL Plus early adopter sites

Crooks, M. G.; Cummings, H.; Morice, A. H.; Sykes, D.; Brooks, S.; Jackson, A.; Xu, Y.

Abstract

Short-acting beta-agonist (SABA) over-use in asthma is harmful for patients and the environment. The Investment and Impact Fund (IIF) 2022/2023 financially rewarded English primary care networks that achieved specific targets, including reducing SABA over-use (RESP-02) and lowering the mean carbon footprint per salbutamol inhaler prescribed (ES-02). SENTINEL Plus is a co-designed quality improvement package that aims to improve asthma outcomes and reduce asthma's environmental impact by addressing SABA over-use. We investigated the impact of (i) the IIF incentives and (ii) SENTINEL Plus implementation on asthma prescribing. Using Openprescribing.net data, we demonstrate that IIF 2022-2023 had no significant impact on the total number of SABA prescribed in England (25,927,252 during 12-months pre- and 25,885,213 12-months post-IIF; 0.16% decrease; p=NS), but lower carbon footprint SABA inhaler use increased (Salamol™ prescribing increased from 5.1% to 19% of SABA prescriptions, p < 0.01). In contrast, SENTINEL Plus sites significantly reduced SABA prescribing post-implementation (5.43% decrease, p < 0.05).

Citation

Crooks, M. G., Cummings, H., Morice, A. H., Sykes, D., Brooks, S., Jackson, A., & Xu, Y. (2024). Reducing short-acting beta-agonist use in asthma: Impact of national incentives on prescribing practices in England and the findings from SENTINEL Plus early adopter sites. NPJ Primary Care Respiratory Medicine, 34(1), Article 6. https://doi.org/10.1038/s41533-024-00363-0

• Journal Article Type: Review
• Acceptance Date: Apr 10, 2024
• Online Publication Date: Apr 29, 2024
• Publication Date: Apr 29, 2024
• Deposit Date: Jun 2, 2024
• Publicly Available Date: Jun 4, 2024
• Journal: NPJ primary care respiratory medicine
• Electronic ISSN: 2055-1010
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 34
• Issue: 1
• Article Number: 6
• DOI: https://doi.org/10.1038/s41533-024-00363-0
• Public URL: https://hull-repository.worktribe.com/output/4664186