D1.115 - Post-emergency asthma management

Asthma is a chronic airway disease. Severe exacerbations need to be treated in hospital emergency departments. A day hospital session has been set up for adults returning home without being admitted to an inpatient unit. This multidisciplinary approach aims to assess, educate and optimise asthma management.

Single-centre retrospective study of 84 patients referred to the post-emergency asthma unit between 03/07/2023 and 29/07/2024. Data collected from the medical records were used to analyse the following indicators: adherence rate to appointments and their median delay, median age, asthma control (as defined by the ACT score), severity of asthma (as defined in the GINA classification), control of inhaled devices (as defined by the SPLF recommendations),  treatment adherence (as defined by the Morisky score), treatment intensification, follow-up methods and rehospitalisation rate at 3 months.

70.2% (n=59) of patients attended their appointment; 5 were excluded. The median time to appointment was 8 days. The male/female ratio was 1:2 and the median age was 34.1 years. Asthma was partially or not controlled in 74% of patients. Asthma was undiagnosed in 24% of patients, classified as GINA 1-2 in 51.9%, GINA 3 in 7.4% and GINA 4-5 in 16.7%. A specialist had never been seen in 68.3% of the patients. Specialist follow-up at the university hospital was suggested to 70.4% of the cohort. Out of these, 60.5% attended their follow-up appointment. 25.9% of patients had a poor technique for taking their device. 18/54 were on background therapy, out of which 55.5% were poorly adherent.  Treatment was increased in 87% of patients and educational management was suggested in 11.1%. One patient was readmitted for an exacerbation within 3 months of the appointment.

Following the inaugural year of operation, this protocol enables asthma patients at risk of exacerbations, most of whom do not receive specialist follow-up, to be reintegrated into an appropriate care pathway.