Abstract Introduction Asthma is a common chronic inflammatory condition of the airway that impacts approximately 339 million people worldwide. Over the past years, the management of asthma has shifted to the utilization of anti-inflammatory reliever inhaler (AIR), encompassing both encompassing both inhaled corticosteroids (ICS)/ long-acting beta-agonist (LABA) and ICS/short acting beta-agonist (SABA) inhalers. This has demonstrated a significant reduction in exacerbations, ED visits and hospitalizations and a 26% reduction in progression to severe exacerbations, healthcare utilization and the need for oral corticosteroids. The Global initiative for asthma (GINA) guidelines since 2019 has started to advocate for single maintenance and reliever therapy (SMART) using formoterol and an ICS. We reviewed compliance with this strategy on hospital discharged asthmatic patients before and after incorporating asthma lectures for both resident and hospitalist groups. Methods We retrospectively collected de-identified data for all patients older than 18 hospitalized with asthma exacerbation under hospitalist team or resident services. Patients without an official diagnosis of asthma or younger than 18 years of age were excluded. We assessed compliance with SMART on discharge, 6 months before and after giving a series of lectures on updates regarding asthma management. Results Following asthma lectures, hospital wide discharge compliance improved from 11.8 - 48.1% (absolute increase of 36.3%, 95% CI 13.3% -59.3%,) statistically significant with a Fisher’s exact test of p0.012, corresponding to a OR = 7. Physicians were seven times more likely to discharge a patient on guideline concordant inhaler therapy after lectures. The hospitalist service accounted for 93.3% SMART adherent prescriptions. Discussion The 2019 GINA guidelines shifted from SABA to SMART, however its implementation has been slow in hospitalized patients due to barriers like knowledge or ‘not-my-role’ barriers. Adherence to this recommendation is proven to reduce severe asthma exacerbations by one-third. Progression to severe exacerbations needing OCS is reduced by 65% compared to SABA and by 37% compared to ICS/SABA. Faculty and fellow engagement in asthma education has significant impact on improving asthma care. Conclusion Asthma lecture series have a significant impact on discharge SMART therapy guideline adherence. This abstract is funded by: none
Chapa-Rodriguez et al. (Fri,) studied this question.