{
  "abstract": "Background Acute Exacerbations in asthma (AEA) can be fatal and both NRAD (National Review of asthma deaths) and BTS have made recommendations around prevention and follow-up post-AEA, however this has been challenging in primary care and further guidance on strategically approaching this is needed. Identification of high-risk patients systematically and proactively is important to optimize care, prevent further exacerbations and effectively treat difficult and severe phenotypes.Methods Retrospective analyses of patients attending emergency departments (ED) with AEA using ED Dataset (fiscal year 2024–2025) was mapped to GP practices within the integrated care board (ICB) and according to socioeconomic status and index of multiple deprivation. Heat map ( figure 1) shows practices with the highest number of ED attendances, where more attention is required for collaborative and integrated outward facing working by the respiratory secondary care teams. Regular monthly sessions with individual practices allows deep dive drilling down to important issues affecting the populations where AEA rates are high and ensure issues addressed like (i) education for staff and patients particularly accounting for locations of more health inequality, (ii) appropriate secondary care review or (iii) referral to other services to evaluate diagnosis and comorbidities.Results 4366 patients were admitted for AEA in the past year of whom, 36% [n=1570] were of white ethnicity, 19% [n=811] black and 7% [n=303] were South Asian. 173 GP practices were reviewed and asthma attendance rate per practice showed 54% practices had rates up to 2%, and 13% of practices above 3%. Figure 1 identifies GP surgeries with highest number of patients with frequent AEA. 404 patients had 2 or more ED admissions. Areas with greatest deprivation showed higher rates of AEA admitted to hospital.Abstract P63 Figure 1Prevalence of Acute Asthma Admissions per registered GP practice in the ICB (Integrated Care Board)Conclusion With one of the worst mortality rates in Europe for asthma, a UK systems-based approach is required to personalize follow-up AEA and is key to prevention of AEA in hotspots of poor asthma control. Specific national guidance is called for to target care to the vulnerable groups in a timely manner and support on the implementation of an integrated approach to ensure delivery of focused attention to those at greatest risk.",
  "authors": [
    {
      "affiliations": [
        "University College Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "S Ryder"
    },
    {
      "affiliations": [
        "University College Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "K Roy"
    },
    {
      "affiliations": [
        "University College Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "R Basra"
    },
    {
      "affiliations": [
        "University College Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "K Pindolia"
    },
    {
      "affiliations": [
        "University College Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "E Davies"
    },
    {
      "affiliations": [
        "North Central London ICB, London, UK"
      ],
      "name": "L Parsons"
    }
  ],
  "title": "P63 Bridging inequality through innovation: systems-based proactive approach to reduce asthma exacerbations in a novel nurse-led model in areas of social deprivation",
  "uid": "0337e332-e78d-51fb-b61a-ca255a8fb781"
}