{
  "abstract": "Introduction The 2024 BTS, NICE, SIGN asthma guidelines endorse anti-inflammatory-based management for everyone aged 12 years and over that are newly diagnosed or have uncontrolled asthma. This represents a paradigm shift away from approaches utilising separate ICS-containing preventer and SABA reliever inhalers. SENTINEL is a quality improvement framework that aims to identify and address SABA over-use in asthma through supported implementation of a MART-based adult asthma guideline.Aim To identify the barriers and facilitators to: i) adoption and persistence of MART treatment among adult asthma patients, and ii) initiation and persistence of MART treatment among healthcare practitioners.Methods This semi-structured interview study recruited primary care practitioners and adult asthma patients from a network of general practices that participated in SENTINEL. Theoretically underpinned interviews were undertaken with clinicians and patients and analysis involved deductive coding to the theoretical domains framework followed by indictive coding within domains.Results Thirteen asthma patients (median [range] age 34 [21–67] years, 7 female) and fourteen primary care clinicians (4 general practitioners, 2 pharmacists, 5 practice nurses, and 3 advanced nurse practitioners) took part in interviews. Fourteen themes were identified ( figure 1). Facilitators included practitioner knowledge and skills (enhanced by SENTINEL), and practice prescribing and appointment systems. Barriers related to access to resources, inconsistent practice across the healthcare system (e.g. emergency departments), and managing patient-related barriers. Patient barriers predominantly related to fear of SABA discontinuation arising from psychological dependence, a lack of understanding of the rationale for MART, and concern about ability to access care in the event of loss of asthma control following a change in treatment.Abstract P61 Figure 1Conclusion There are a range of barriers to adoption and persistence with anti-inflammatory-based asthma management that need to be acknowledged and addressed if the 2024 BTS, NICE, SIGN asthma guideline recommendations are to be fully implemented in practice. Ensuring clinicians have the required knowledge and skills to support patients transition to MART as part of a positive therapeutic relationship, and adoption of a system wide approach to ensure a consistent approach to asthma management, will provide the greatest chance of successful implementation of anti-inflammatory-based asthma management.",
  "authors": [
    {
      "affiliations": [
        "Birmingham City University, Birmingham, UK"
      ],
      "name": "J Dyson"
    },
    {
      "affiliations": [
        "NHS Humber Health Partnership, Hull, UK"
      ],
      "name": "H Cummings"
    },
    {
      "affiliations": [
        "Birmingham City University, Birmingham, UK"
      ],
      "name": "G Williams"
    },
    {
      "affiliations": [
        "AstraZeneca, London, UK"
      ],
      "name": "V Raja Gopal"
    },
    {
      "affiliations": [
        "AstraZeneca, London, UK"
      ],
      "name": "M Watt"
    },
    {
      "affiliations": [
        "AstraZeneca, London, UK"
      ],
      "name": "T Morris"
    },
    {
      "affiliations": [
        "Hull York Medical School, Hull, UK"
      ],
      "name": "MG Crooks"
    }
  ],
  "title": "P61 Barrier and facilitators to primary care practitioner prescribing and patient adoption of anti-inflammatory, maintenance and reliever therapy (MART) for adults with asthma",
  "uid": "b420fe08-852f-5c37-b19a-fb42352873c8"
}