JMIR Publications

ABSTRACT

The Specialised Services Pathway for Severe Asthma (NHS Commissioning Board, 2012/2013) recognises the burden of uncontrolled disease, ordinarily amenable to anti-inflammatory medications and the progression to longer term ‘severe’ disease necessitating high-cost therapies (e.g. Bronchial Thermoplasty). The identification and appropriate referral to a specialist asthma service is often delayed by several months or years due to poor recognition and understanding of symptom severity. Current severe asthma services may take several months to provide a comprehensive multi-disciplinary assessment often necessitating multiple hospital visits and costing up to £5000 per patient. MISSION – Modern Innovative Solutions to Improve Outcomes in Severe Asthma is a novel service model pilot developed by asthma specialists from Portsmouth and Southampton asthma services. MISSION Severe Asthma identified patients with poorly controlled disease from General Practice (GP) databases who had not been under secondary outpatient care in the last 12 months or who were not known to secondary care. In one-or two-stop assessments, a thorough review of diagnosis, disease phenotype and control is undertaken. This Protocol outlines a mixed methods study to assess the impact on disease control, unscheduled healthcare usage and quality of life in patients seen in the MISSION clinic compared to a closely matched cohort who declined to attend.