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Published on: November 4, 2010
Can we measure whether asthma guidelines lead to improved care?
Ronnie Tan1,2, Anna Murphy2, Chris Brightling1,2
1Department of Respiratory Sciences, University of Leicester, Institute for Lung Health, NIHR Respiratory Biomedical Research Centre, Leicester, UK.
Insights
New joint UK asthma guidelines aim to reduce confusion. Prescription data will track adoption of new asthma treatments like anti-inflammatory reliever therapy (AIR) and maintenance and reliever therapy (MART) to improve patient care.
Area of Science:
- Pulmonology
- Clinical Guideline Development
- Health Informatics
Background:
- Previous asthma guidelines from BTS, SIGN, and NICE had key differences, causing confusion and hindering adoption.
- A new joint BTS/SIGN/NICE asthma guidance is forthcoming, offering a chance to evaluate guideline implementation.
- Accurate prescription data is crucial for assessing the uptake of new asthma management strategies.
Purpose of the Study:
- To evaluate the potential impact of new joint UK asthma guidance on clinical practice.
- To explore the use of prescription data (e.g., OpenPrescribing) as a proxy for guideline adoption.
- To assess the feasibility of linking prescription data to clinical outcomes (e.g., HES) for evaluating new asthma therapies.
Main Methods:
- Utilizing prescription data from platforms like OpenPrescribing to monitor guideline adherence.
- Potentially linking prescription data with Hospital Episode Statistics (HES) to analyze clinical outcomes.
- Focusing on the accurate coding of anti-inflammatory reliever therapy (AIR) and maintenance and reliever therapy (MART) with inhaled corticosteroid/formoterol.
Main Results:
- The study outlines a methodology for assessing guideline adoption and impact.
- It highlights the importance of accurate data capture for novel asthma treatment approaches.
- Prescription data offers a viable surrogate for measuring real-world guideline implementation.
Conclusions:
- Accurate prescription data is essential for evaluating the adoption and impact of new UK asthma guidance, particularly for AIR and MART therapies.
- This approach can identify barriers to guideline uptake and inform targeted interventions.
- Improving guideline adoption is key to enhancing asthma care based on current evidence.
Abstract:
The British Thoracic Society (BTS) and Scottish Intercollege Guidelines Network (SIGN), as well as National Institute for Health and Care Excellence (NICE), have previously produced separate asthma guidance differing in some key aspects in diagnosis and management leading to confusion, potentially hampering guideline dissemination and uptake. While there are inherent challenges, the upcoming release of new joint BTS/SIGN/NICE asthma guidance presents an opportunity to assess guideline adoption and its impact on clinical practice. The use of prescription data via databases such as OpenPrescribing can be used as a surrogate for guideline adoption and potentially linked to clinical outcomes such as hospital episode statistics (HES). The potential recommendation for anti-inflammatory reliever therapy (AIR) and maintenance and reliever therapy (MART) with inhaled corticosteroid/formoterol combination therapy in the next iteration of UK asthma guidance will require the accurate coding for the respective therapeutic approaches on prescribing platforms in order to assess their impact in real-life clinical practice. This could then direct targeted measures to improve wider guidance adoption leading to better clinical care in asthma based on up to date evidence.
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