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    Consultation on new and updated NICE indicators: GID-IND10330 to GID-IND10335 & GID-IND10337 to GID-IND10338

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    Asthma: MART (high risk patients)

    GID-IND10320: The percentage of patients with asthma aged 12 years or over with a risk factor for poor outcomes who are receiving maintenance and reliever therapy (MART).

    Indicator type

    General practice indicator suitable for use in the QOF

    Rationale

    This indicator aims to improve asthma control and prevent future events such as exacerbations, hospitalisations and deaths.

    People with medication over-use or previous emergency attendance at hospital for an exacerbation are more likely to be at greater risk of poor outcomes (including death, hospital admission, and the need for out-of-hours contacts or visits to an emergency department for asthma exacerbations). A focus on improved medicines optimisation in this population aims to support better asthma control through individualised, patient-centred care.

    A risk factor for poor outcomes is defined as any of the following in the year preceding the current reporting period:

    • 6 or more short-acting beta2 agonist (SABA) inhalers

    • 2 or more oral corticosteroids

    • 2 or more visits to an emergency department for asthma

    • Any hospital admission for asthma.

    Testing by NICE in June 2025 of Clinical Practice Research Datalink (CPRD) Aurum found that using this definition of risk factors for poor outcomes equates to around 29% of all people aged 12 years or over with asthma. CPRD Aurum March 2025 (Version 2025.03.001) [Data set]. Clinical Practice Research Datalink. https://doi.org/10.48329/6570-ge08.

    Specification

    Numerator: The number of patients in the denominator who are receiving maintenance and reliever therapy (MART).

    Denominator: The number of patients with asthma aged 12 years or over with a risk factor for poor outcomes.

    Definition: Risk factors for poor outcomes include any of the following:

    • Prescription of 6 or more short-acting beta2 agonist (SABA) inhalers or 2 or more oral corticosteroids in the year preceding the reporting period.

    • Two or more visits to an emergency department or any hospital admission for asthma in the year preceding the reporting period.

    Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines or does not attend.

    Questions for consultation:

    7. Questions 5 and 6 for indicator 2025-1 (annual review in high risk patients) related to the definition of 'risk factors for poor outcomes' are also relevant to this indicator. Do you have any additional comments on risk factors that specifically relate to this indicator?