Improving adolescent asthma care: reducing SABA overuse through MART implementation

Overreliance on short-acting beta-agonists (SABAs) is linked to poor asthma control and increased risk of exacerbations. Current guidelines recommend maintenance and reliever therapy (MART) for patients aged ≥12 years to reduce SABA use and improve outcomes.

The aim was to increase the percentage of 12-18-year-olds issued ≥3 salbutamol inhalers in the past year, who are transitioned to MART, to >50% by May 2025.

An EMIS search identified adolescents prescribed ≥3 salbutamol inhalers in the last year. Eligible patients were invited for structured face-to-face consultations to assess true overuse, provide asthma education by developing an adolescent-friendly education tool, develop personalised asthma action plans, and initiate MART where appropriate. A re-audit was conducted after interventions.

The initial audit identified 22 patients; eight were already on MART. Of the remaining group, 10 attended consultations, leading to five further MART initiations. The re-audit identified 23 patients, with 10 (43%) on MART. Several cases of apparent overuse reflected practical issues (for example, duplicate inhalers for school/sports) rather than poor control. Despite not reaching the >50% target, patient education, prescribing accuracy, and clinical team awareness improved significantly.

This quality improvement project demonstrated that structured reviews can clarify true SABA overuse and support safer, guideline-aligned prescribing in adolescents. The project delivered important qualitative gains through personalised action plans, improved inhaler technique education, and greater clinical awareness. These findings highlight the value of multidisciplinary collaboration and sustained audit cycles in improving adolescent asthma care.