Most Proposed Topic :
Clinical Safety and Quality Service I (projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors: (including presenting author): :
TAI CE, SIN KM, HONG YF, Emily LEUNG, LAW MW
Affiliation: :
M&G Respiratory TMH
Introduction: :
Asthma is a common, chronic respiratory disease affecting 1-18% of the population in different countries. Asthma is characterized by variable symptoms of wheeze, shortness of breath, chest tightness and/or cough, and variable expiratory airflow limitation. Both symptoms and airflow limitation characteristically vary over time and in intensity. These variations are often triggered by factors such as exercise, allergen, or irritant exposure, change in weather, or viral respiratory infections. We can now explore the potential for changing disease trajectory and inducing remission. However, biologics are not a panacea for all severe asthma sufferers and despite their success there remains substantial unmet clinical need. We review the pathogenesis of asthma, phenotyping the heterogeneity of asthma, currently licensed and future biologic agents, how to choose the initial biologic, assessing the response, remission and switching of biologic therapies.
Objectives: :
Treatment Goals: Discuss the goals of biologic therapy, such as reducing asthma symptoms, improving lung function, and minimizing the need for rescue medications or oral corticosteroids. Eligibility and Selection: Provide information on the eligibility criteria for biologic therapy and the process of selecting the appropriate biologic medication based on individual patient characteristics, including biomarkers and asthma severity.
Methodology: :
Asthma that is difficult to treat is considered to be severe when control remains poor despite measures that adequately address each of these three variables - good adherence and correct inhaler technique - exposure to relevant allergens, irritants and smoking should be avoided, and comorbidities need to be assessed and managed appropriately - treatment with high-dose ICS together with a second controller is still needed to control the disease, he/she has severe asthma Education includes i. Indication, patient selection, benefit and side-effect of biologic therapy ii. Technique for use of prefilled auto-injector or prefilled syringe for biologic therapy. iii. Teach the patient self-management techniques, including recognizing early signs of asthma exacerbations, proper inhaler technique, and how to develop an asthma action plan. Encourage the patient to actively participate in their asthma management and communicate any concerns or changes in symptoms to their healthcare provider.
Result & Outcome: :
Totally 19 patients had recruited for education on biologic therapy Mar 2020 to Mar 2023. ● Using rescue pack: reduction 49% ● Asthma exacerbation rate: reduction :64% ● Readmission rate: decrease 70%
After recruited for education on biologic therapy, educate the patient about the potential benefits of biologic therapy, such as reduced asthma exacerbations, improved quality of life, and decreased reliance on other asthma medications. Also, discuss possible risks and side effects associated with biologic treatment and how they can be managed. Thus although wider availability of current biologics are needed, additional pharmacological and non-pharmacological interventions are still required. Careful phenotypic assessment of patients including current and novel predictive biomarkers will help to choose the best biologic for each patient and guide decisions on early switching if required. We are progressing to a precision medicine future for severe asthma. Remember, it is crucial to individualize education based on each patient's specific needs, preferences, and comprehension level. Regular communication and follow-up with healthcare professionals are essential to address any questions or concerns that may arise during the course of biologic therapy.
