Page 54 - Škrgat, Sabina, ed. 2022. Severe Asthma - Basic and Clinical Views. Koper: University of Primorska Press. Severe Asthma Forum, 1
P. 54
is warranted, as in the case of a pregnant dif- discharge outcomes.63 That showed no signifi-
ficult asthma patient. Such channels can also cant differences in exacerbations or quality of
severe asthma forum 1: severe asthma - basic and clinical views interlink with acute care pathways and fol- life between the 2 intervention arms, though
low-up patients who have had an acute asth- exacerbations remained relatively common
ma admission to ensure optimised post-dis- in both. As our own group have subsequently
charge care that seamlessly interlinks with shown, a combined MDT approach that links
the difficult asthma MDT. An early study in with the difficult asthma MDT may deliver
of such post-discharge support identified im- the best results for such post-discharge asthma
provements in patient knowledge about their care pathways (see section; Impact of Com-
asthma and relevant actions to take which bined Difficult Asthma MDT Approaches).64
was accompanied by reduced emergency GP
call-outs in the following 4 months but no re- It can be readily appreciated that, as with
duction in hospitalisations for acute asthma.61 the Asthma Specialist Physician, the Asth-
That mixed outcome might in part reflect the ma Nurse Specialist needs to have well devel-
nature of the applied intervention. A subse- oped understanding of the nature, assessment
quent study in our own Institution assessed and management of difficult asthma and rel-
impact of Asthma Nurse Specialist patient evant comorbidities. Overlapping experience
management as part of a Respiratory Physi- in other areas of Respiratory Medicine and
cian-led pathway for patients with acute asth- in Allergy are desirable to facilitate these re-
ma in the Acute Medical Assessment Unit.62 quirements. They also need expertise in pa-
This intervention led to significant improve- tient education allied to good communica-
ments in achieving safe discharge criteria tion skills, the ability to interact with a range
and reduction in 30-day readmission, but at of healthcare professionals and to apply new
the expense of an extra day in hospital for technologies as they emerge.
the index admission. The role of an Asth-
ma Nurse Specialist in such post-discharge The Asthma Specialist Pharmacist
pathways has also been demonstrated in a
UK randomised controlled trial comparing As the portfolio and complexity of availa-
nurse-delivered and physician-delivered post ble asthma pharmacotherapies expands, the
Asthma Specialist Pharmacist has become an
increasingly important member of the Asthma
Figure 3. The Multidimensional Role of an Asthma Nurse Specialist.
Abbreviations: FENO = Fractional Exhaled Nitric Oxide.
ficult asthma patient. Such channels can also cant differences in exacerbations or quality of
severe asthma forum 1: severe asthma - basic and clinical views interlink with acute care pathways and fol- life between the 2 intervention arms, though
low-up patients who have had an acute asth- exacerbations remained relatively common
ma admission to ensure optimised post-dis- in both. As our own group have subsequently
charge care that seamlessly interlinks with shown, a combined MDT approach that links
the difficult asthma MDT. An early study in with the difficult asthma MDT may deliver
of such post-discharge support identified im- the best results for such post-discharge asthma
provements in patient knowledge about their care pathways (see section; Impact of Com-
asthma and relevant actions to take which bined Difficult Asthma MDT Approaches).64
was accompanied by reduced emergency GP
call-outs in the following 4 months but no re- It can be readily appreciated that, as with
duction in hospitalisations for acute asthma.61 the Asthma Specialist Physician, the Asth-
That mixed outcome might in part reflect the ma Nurse Specialist needs to have well devel-
nature of the applied intervention. A subse- oped understanding of the nature, assessment
quent study in our own Institution assessed and management of difficult asthma and rel-
impact of Asthma Nurse Specialist patient evant comorbidities. Overlapping experience
management as part of a Respiratory Physi- in other areas of Respiratory Medicine and
cian-led pathway for patients with acute asth- in Allergy are desirable to facilitate these re-
ma in the Acute Medical Assessment Unit.62 quirements. They also need expertise in pa-
This intervention led to significant improve- tient education allied to good communica-
ments in achieving safe discharge criteria tion skills, the ability to interact with a range
and reduction in 30-day readmission, but at of healthcare professionals and to apply new
the expense of an extra day in hospital for technologies as they emerge.
the index admission. The role of an Asth-
ma Nurse Specialist in such post-discharge The Asthma Specialist Pharmacist
pathways has also been demonstrated in a
UK randomised controlled trial comparing As the portfolio and complexity of availa-
nurse-delivered and physician-delivered post ble asthma pharmacotherapies expands, the
Asthma Specialist Pharmacist has become an
increasingly important member of the Asthma
Figure 3. The Multidimensional Role of an Asthma Nurse Specialist.
Abbreviations: FENO = Fractional Exhaled Nitric Oxide.
