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The UK's primary care sustainability network

Disease control

There are eight projects in this section

Introduction

Poor disease control, low adherence to preventer inhalers and over-reliance on short-acting beta agonist (SABA) inhalers are all linked to poorer clinical outcomes and higher carbon emissions.

There are eight projects in this section will help you to find opportunities for improvement in daily clinical practice and through audit. Some of the projects are really quick such as changing the prescribing interval of SABA inhalers and others, such as identifying patients at risk of poor control will be an ongoing process. Scroll to the bottom of the page to see the different projects.

We recommend that all clinicians read through the section on approach to consultations.

Target population

Patients on the QOF Asthma register

IIF targets and monitoring

The projects in this section will help you to meet indicators RESP-01 and RESP-02 in the Network Contract DES Investment and Impact Fund. These indicators target poor asthma control by counting the number of patients on the QOF Asthma register prescribed 6 or more SABA inhalers or less than 3 inhaled corticosteroids (ICS) inhalers in 12 months.

Please note that the accepted definition of SABA over-reliance is 3 prescriptions or more in 12 months (Global Initiative for Asthma). The IIF indicator is set at 6 or more SABA prescriptions to focus on the highest priority patients and ensure the targets are pragmatic and achievable. You may however wish to review the disease control of all patients using 3 or more SABA a year. The National Bundle of Care for Children and Young People with Asthma recommends reviewing all children on 3 or more SABA inhalers per year.

We recommend that you start by finding out how your practice is doing on these indicators, and therefore how much work you will need to do to achieve the IIF targets.

Searches and Templates

Primary Care IT have developed searches to help identify patients at risk of poor control as well as creating an asthma template that pulls out objective information on inhaler use from the clinical record to help with the asthma review converstaion. Register for the template and searches. It only takes a minute.

Education

In this education video, Dr Katherine Hickman, GP and Vice-Chair of the Primary Care Respiratory Society, discusses the problems with SABA over-reliance and the importance of ensuring regular preventer inhaler use. She also explain the role of Maintenance and Asthma Reliever Therapy (MART).