P75 Development of the UK severe asthma registry as a performance-monitoring quality improvement platform
Pfeffer, PE Brown, T Kramer, A Patel, M Gonem, S Patel, P Idris, E Shrikrishna, D Prior, K Mansur, AH
Pfeffer, PE
Brown, T
Kramer, A
Patel, M
Gonem, S
Patel, P
Idris, E
Shrikrishna, D
Prior, K
Mansur, AH
Affiliation
Barts Health NHS Trust; Portsmouth Hospitals University NHS Trust; Queen’s University Belfast; The Dudley Group NHS Foundation Trust et al
Other Contributors
Publication date
2025-11-2
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
ntroduction and Objectives The UK Severe Asthma Registry (UKSAR) was established to facilitate research and quality improvement including performance monitoring across UK severe asthma centres. We here describe its development and refinement for the latter of those objectives. The selection of performance outcomes measures for severe asthma clinical quality improvement from clinician and patient perspectives, data collection, and assessment of clinical variation across severe asthma centres is presented.
Methods After relevant stakeholder consultation (patients, commissioners and clinicians), outcomes measures relating to exacerbations, oral corticosteroid exposure, asthma-related ED attendances and hospital admissions, asthma control and quality of life were selected with appropriate case-mix adjustment to help identify unexplained clinical variation. Over 2018–2025, the number of participating centres increased from 17 to 42. To date, baseline data has been entered for 18,473 patients, with data meeting the agreed quality threshold for 12,792 patients.
Results Compared to 2018, in 2024 patients were older when first reviewed (54.0 vs 50.3 years), less likely to be never smokers (58.7% vs 65.8%) and to be on mOCS at baseline (25.5% vs 47.1%).
Analysis of variation in outcomes between centres, after case-mix adjustment and allowing for effect of centre size, shows relatively few examples of significant variation in outcomes between centres. Where variation was evident, for example in improvement in asthma control ACQ6 score from baseline to follow-up (see figure 1) high-performing centres could be identified to share best-practice.
Conclusions Regular discussion at UKSAR registry meetings, at which representatives from each severe asthma centre are present, of outcome measures and related latest research, including UKSAR research, together with sharing of best practice may explain why there is relatively little evidence of variation in clinical outcomes between centres. UKSAR shows that there are an increasing number year-on-year of patients on severe asthma biologic treatments and of hospitals both prescribing biologics and entering data for quality improvement. However, a limitation of UKSAR is that it cannot evaluate the presence of ‘hidden’ severe asthma not known to specialist services, a continuing issue given the harm that results from delays in appropriate diagnosis and management, and accompanying oral corticosteroid associated comorbidities.
Citation
Pfeffer P, Brown T, Kramer A, et alP75 Development of the UK severe asthma registry as a performance-monitoring quality improvement platformThorax 2025;80:A178.
Type
Article