Optimisation of ASthma In Those With Uncontrolled Symptoms (OASIS) (OASIS)

Optimisation of ASthma In Those With Uncontrolled Symptoms (OASIS) in Primary Care Using a Digital Consultation Tool During the COVID-19 Pandemic

A digital tool, called ReferID has been developed to facilitate the review of asthma patients. It aims to assist in the identification of patients with uncontrolled and/or severe asthma and to ensure a timely referral to secondary care where appropriate. To validate the tool, patients will be randomised to have a review with a healthcare professional using tool to facilitate the review or to continue receiving usual care. Outcome measures including exacerbation frequency and level of asthma control will be assessed at 12 months.

An electronic randomisation programme will be used to assign the patient to each arm of the study in primary care. However during the review, masking will not be possible.

The asthma review will be undertaken by a healthcare professional with the use of the ReferID tool in primary care

The ReferID tool is a digital tool which can be used to facilitate a review of asthma in primary care

Measured by the number of courses of oral corticosteroids measured at 12 months before and 12 months after initial consultation. Exacerbations are defined as the need for oral corticosteroids prescribed by a healthcare professional for a minimum of 3 consecutive days in the context of worsening asthma symptoms.

Asthma control questionnaire completed on day 1 and at 12 months after initial consultation. Total score ranges from 0-6, with 0 = no impairment due to asthma, 6 = maximum impairment due to asthma.

Change in primary care salbutamol prescription refill frequency 12 months before and 12 months after initial consultation.

Frequency of emergency department and/or hospital admission due to acute asthma 12 months before and 12 months after initial consultation.

Change in quality of life score at day 1 and at 12 months (mAQLQ). Score for each question ranges from 0-7, with 0 = totally limited, 7 = not limited at all. The score is calculated as an average for each domain, with a clinically minimum difference of 0.5.

Adherence to inhaled corticosteroids 12 months before and 12 months after initial consultation (measured as a percentage of the number of doses of inhaled corticosteroids issued/the expected number of doses in 12months).

Proportion of subjects referred to secondary care for further assessment of suspected severe asthma or work-related asthma

Proportion of subjects referred to secondary care with confirmed severe asthma initiated on biologic therapies

Acceptability of using the ReferID tool by completion of questionnaire, with users providing feedback using a likert scale, with 1 = poor, 5 = excellent.

Inclusion Criteria: All asthma patients with 1 of more exacerbations in the last 12 months or receiving high dose inhaled corticosteroids. Patients able and willing to provide informed consent. Patients aged 18 and over. Exclusion Criteria: Patients who lack capacity. Patients who do not have a diagnosis of asthma Patients who are unable to provide informed consent Patients under the age of 18 Patients already under a severe asthma centre