10 May 2023
Over 1000 patients in Greater Manchester receive asthma reviews to improve asthma diagnosis and management through STARRS-GM
Over 1000 patients in Greater Manchester have received asthma reviews through the LungHealth platform, helping to improve asthma diagnosis and management through the Standardised Asthma Reviews and Reduction in SABA model in Greater Manchester (STARRS-GM) project.
Health Innovation Manchester has a joint working agreement with AstraZeneca and is working through the Standardised Asthma Review and Reduction in SABA model in Greater Manchester (STARRS-GM) using LungHealth software, via National Services for Health Improvement (NSHI).
The project aims to improve the outcomes for adults living with asthma in the region, through proactive identification and reviews with high-risk patients to help optimise their asthma management.
The STARRS-GM project implements high quality and consistent AI-guided asthma consultations through the LungHealth software, with a focus on high-risk patients.
Through the LungHealth software, patients are provided with a sophisticated and thorough guided review that is controlled and monitored by clinicians and healthcare professionals, making for more optimal asthma care and management.
To date, of the 1000-plus patients that have been reviewed through the LungHealth software, over 900 of these patients have been reviewed remotely, either by a mobile telephone or a video device. This remote care has helped to improve the patient experience by providing improved care in a comfortable environment.
A large portion of the patients reviewed have gone on to receive a Personalised Asthma Action Plan (PAAP) as part of their care, helping to monitor and manage their asthma more efficiently. As part of these plans, appropriate patients have been referred to specialist services after streamlined assessments, helping to connect the care services available across Greater Manchester health and care system.
Additionally, a large portion of these reviews have shown that dry powder inhalers have been increasingly prescribed as an alternative to aerosol inhalers, which not only provides a more optimal option of treatment for many patients, but also helps to reduce the overall carbon footprint of asthma devices in Greater Manchester.
Danielle Perkins, Practice Manager at Cherry Medical Practice in Salford, said: “We are trying to increase uptake in Asthma reviews and make sure they are undertaken in a standardised way so that regardless of where you live within Greater Manchester GM patient levels of care are the same. Also, where possible educate patients about the effect certain inhalers can have on the environment and promote proper disposal of used inhalers.
“All eligible asthma patients were offered an appointment and a chance to engage in the service. For those that chose to engage we made use of the LungHealth software to standardise everyone’s care and made appropriate changes to Asthma medication when needed.
“Making use of technology advances to help standardise patient care where appropriate can be very effective. When setting up studies we need to be mindful as to when we plan for them to start as this can impact the number of patients that will engage.”
Sunil Thacker, Director at Thacker’s Pharmacy in Wythenshawe, said: “My objective was to review over-treated patients in Northenden and Brooklands PCN in South Manchester using the LungHealth platform and a Fractional Exhaled Nitric Oxide (FeNO) machine to support the consultation. The objective was to try and reduce high dose steroids for appropriate patients. This would also include changing some patients to Maintenance and Reliever Therapy (MART) (to reduce SABA use) and from aerosol to dry powder inhalers as part of the green agenda.
“I had one patient who was not taking his steroid inhaler regularly or correctly and he had atopic asthma with a FeNO of 57. I changed his inhaler to dry powder which suited his technique and asked him to regularly take his inhaler. He came back after 4 weeks, and his Asthma Control Test score (ACT) went up from 19 to 23 and his FeNO went down to 25. His asthma scores improved despite changing him to a lower strength steroid as I was able to recommend ‘MART therapy’ which allows patients to use one inhaler for everything rather than two, as his steroid could now be reduced to medium strength.”
Additionally, this work has included education resources for health care professionals and patients, alongside consultant-led multi-disciplinary team (MDT) and streamlined referrals to specialist services.
The Asthma Multi-disciplinary Team (MDT) service for primary care has been made available as an education session, aimed at providing advice and guidance on asthma diagnosis, treatment, and management. The sessions also provide the opportunity to discuss complex cases with secondary and specialist care clinicians from GM Severe Asthma Service.
To date, the Asthma MDT sessions ad educations resources have been accessed by over 120 clinicians across Greater Manchester.
Samantha Arthington, Practice Nurse at Cherry Medical Practice in Salford, said: “The experience was excellent. They were friendly and approachable; I was advised to refer the patient to an upper airways clinic that I otherwise wouldn’t have known existed. They were great at giving advice on inhalers and asthma management. I found the advice I received helpful and clear. I came out the MDT with a plan of care for a complex patient that I otherwise would have been unsure how best to deal with.
“When you are a sole practice nurse like I am it can be difficult to make decisions about complex patients and we don’t always have other colleagues to discuss this with. I think the MDT is an excellent resource and I would recommend to other practice nurses.”
GB 44066 – April 2023