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Pharmacotherapy

Quality improvement project to increase screening and referral for biologic therapy for patients with uncontrolled asthma

, DNP, MS, RN, AGACNP-BC, , DNP, FNP-BC, FAANP, , DNP, MS, RN, CCM, CNE & , MD
Pages 2386-2394 | Received 06 Aug 2021, Accepted 15 Dec 2021, Published online: 03 Jan 2022
 

Abstract

Background

Asthma is a treatable chronic disease of airway inflammation with varying levels of control and severity. Biological therapy is an effective evidence-based treatment for patients with allergic and eosinophilic phenotypes of asthma who are classified as poorly controlled moderate to severe asthma. Yet, evidence-based treatments are infrequently used to support effective care of poorly controlled moderate and severe asthma. This quality improvement (QI) project aimed to increase the number of patients with uncontrolled moderate to severe asthma at an outpatient asthma center who are screened and referred for biologic therapy when appropriate.

Methods

A guideline-based biologic screening protocol was implemented using plan-do-study-act (PDSA) methodology allowing for a systematic approach for implementation, monitoring and making adjustments. A pre- and post-independent groups comparative design was utilized to evaluate screening and referral data.

Results

Screening improved significantly from pre- (n = 30, 23.8%) to post-implementation (n = 17, 70.8%), p < 0.001; phi = .372. Referrals to biologics also improved from 42.4% (n = 28) to 93.3% (n = 14), p < 0.001; phi = .396. Providers reported increased knowledge, confidence, and satisfaction with the asthma screening protocol at post-implementation.

Conclusions

The implementation of an asthma screening protocol for asthma patients in an ambulatory center is an effective way of increasing screening for eligibility for biologic therapy. Adhering to the standard of care based on evidence-based guidelines increased access to biologic therapy with a higher percentage of patients being referred for therapy.

Additional information

Funding

Dr. Rushton received funding from HRSA Primary Care Training and Enhancement Program (TOBHP29992) which is not related to this work.

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