Leads:
Dr Sarah Damery, Dr Janet Jones, Prof Kate Jolly (Long-Term Conditions)
Dates:
01/04/2023 to 30/06/2024
Background:
Uncontrolled severe asthma can reduce patient quality of life and increase the need to use oral corticosteroids (OCS) and ‘rescue and reliever’ medications, known as short-acting beta agonists (SABA), to manage symptoms. Several types of severe asthma can be treated using asthma biologics, which are specialist treatments that act on specific cells in the body to stop lung inflammation. However, patients with severe asthma may be unable to access biologics treatments because they do not have a severe asthma diagnosis. Diagnosis can be helped by the use of Fractional Exhaled Nitric Oxide (FeNO) devices, but these are not currently used widely in primary care, where most referrals to severe asthma services are made. There are also known inequalities in access to diagnosis and treatment for many patients, particularly for patients from the most socioeconomically deprived backgrounds and those in ethnic minority groups.
Clinicians from University Hospitals of North Midlands are leading a project to identify and assess patients with severe asthma from socioeconomically deprived and ethnic minority communities in four primary care networks (PCNs) across Staffordshire and Stoke-on-Trent. This will involve using FeNO devices in primary care to improve diagnosis and treatment of severe asthma in these under-represented groups.
Policy and Practice Partners:
University Hospitals of North Midlands, West Midlands Academic Health Sciences Network.
Co-Funding partners:
The InHIP programme is funded by the NHS Accelerated Access Collaborative; the evaluation is being supported by NIHR ARC West Midlands.
Aims and Objectives:
The ARC West Midlands is evaluating the effectiveness of the inHIP programme, in order to make recommendations that can inform future design and commissioning for severe asthma services. Specific objectives are to describe the implementation of FeNO testing in primary care for the populations being targeted in Staffordshire and Stoke-on-Trent, to analyse data on clinical and patient experience outcomes, and to understand the strengths and limitations of the approach taken so that further service development work can be carried out.
Methods:
The evaluation will use mixed methods. Qualitative work will involve up to 20 semi-structured interviews with key stakeholders across primary, secondary and tertiary care who are involved in providing severe asthma care and training/education for primary care staff as part of the InHIP programme. Quantitative work will involve analysing routinely-collected patient and process data to understand whether the InHIP programme has been associated with improvements in clinical and patient experience outcomes comparing baseline to project end. This will include rates of diagnosis and referral, changes in prescribing and medication use, onward referrals for biologics treatments, changes in patient asthma control and patient experience of FeNO testing in primary care.
Main Results:
Ongoing study.
Conclusions:
Ongoing study.
Implications for Implementation:
Ongoing study.
Protocol:
N/A
Publication:
N/A