SABA-free asthma pathways in a large PCN
Outcomes and learning
Outcomes
-
Improved patient safety: by reducing SABA prescriptions, patients are less likely to develop harmful patterns of overuse.
-
Better alignment with guidelines: the pathway reflects the latest Wessex (HIOW), GINA, and BTS, NICE and SIGN recommendations.
-
Enhanced diagnostic accuracy: RNS-led assessments using FeNO, spirometry, and detailed histories improved confidence in diagnosis.
-
Positive patient engagement: patients appreciated being started on a single inhaler that both controls inflammation and relieves symptoms.
-
System-wide prescribing impact (OpenPrescribing data):
-
SABA monotherapy prescriptions reduced from the 76th percentile in November 2021 to the 41st percentile in September 2025, demonstrating a significant shift in practice and patient outcomes.
-
Learning
-
Early education is vital: patients must understand why ICS-formoterol is prescribed instead of the familiar "blue inhaler".
-
Multidisciplinary collaboration works: success depended on GP, nurse, and pharmacist alignment, supported by clear local guidelines.
-
Pathways must evolve: regular updates to reflect national and local guidance ensure best practice and sustainability.
-
Children's inclusion matters: extending ICS-formoterol PRN use to those aged 12 or over closes a gap in early treatment and prevention.
These learnings can be applied by embedding SABA-free prescribing protocols into electronic systems, expanding nurse-led education, and monitoring long-term outcomes across both adult and paediatric populations.
This page was last updated: