C102-22 Patient Supports Needed to Transition to Maintenance and Reliever Therapy for Asthma

Abstract Introduction Single maintenance and reliever therapy (MART), or the use of an inhaled corticosteroid and rapid long-acting beta agonist (ICS/formoterol) for both maintenance and relief of acute asthma symptoms is the preferred treatment pathway for patients with moderate to severe asthma. While use of MART significantly reduces asthma exacerbations, it has been poorly adopted by patients and clinicians. Our objective was to understand how to better support patients in their transition to MART to ultimately improve MART adoption. Methods We conducted 30 semi-structured interviews via Zoom with patients with moderate to severe asthma who were evaluated at the Yale Center for Asthma and Airway Disease who were eligible for MART and either currently on MART or not on MART. Patients were asked to identify knowledge needed to help transition to MART and what mode of education would be most effective for them. Interviews were recorded, transcribed, and coded for themes. Results Of the 30 interviewees, 21 (70%) were women with a median age of 38 years. Most interviewees identified as non-Latinx white (N = 19, 63%), had completed a college degree or above (N = 18, 60%), and had private insurance (N = 19, 63%). Patients expressed the need for educational content about MART including knowledge of why MART works and a rationale for the decision to transition to MART. As one patient said, “Why would I need to use MART? Why does ICS/formoterol also work as a reliever in the acute situation? What are the benefits?” Patients also wanted to know side effects of MART and how to use MART. Patients highlighted the need for clear communication in the transition to MART. As one participant said, “Explain things in layman’s terms. Take the time to explain it in simpler terms that aren’t technical jargon.” Additional modes of education felt to be beneficial included written instructions, demonstration of inhaler use, and a visual form of education (Table 1). Several patients endorsed a preference for maintenance inhalers other than ICS/formoterol. Conclusion More robust education strategies specific to a patient’s identified knowledge gaps with clear communication regarding rationale for transition to MART and MART’s efficacy and safety are needed to aid patients with asthma in their transition to MART. In addition, alternative anti-inflammatory reliever (AIR) strategies should be considered for patients who prefer an alternative inhaler to ICS/formoterol. We anticipate that addressing these patient specific gaps will improve the adoption of AIR strategies. This abstract is funded by: American Lung Association