A Patient-centred approach to understanding the barriers to Accessing and Engaging with asthma care (PACE)

Background: UK asthma outcomes for children and adults are poor. Patients often miss review appointments and/or take their asthma preventer treatment infrequently. Little research has explored why poor engagement with asthma services exists/persists. Aims: The PACE programme aims to improve asthma outcomes by designing and evaluating services that meet patients’ needs and preferences. Here we report the outcome of our first professional/expert reference group (ERG) meeting in Nov. 2024, on perceived barriers to engaging with routine asthma care. Methods: UK medical and nursing specialists in asthma participated in the on-line ERG. Informed by early insights from the literature search and, facilitated with digital Interactive tools (GroupMap, https://www.groupmap.com/), they discussed key barriers to engagement with routine asthma care. Results: Expert opinion on the contexts of change, highlighted ethnicity and deprivation as priority issues (ahead of issues of place/geography) as important barriers to access. In meeting the shared challenge of healthcare practitioner and patient interaction, face-to-face, digital and/or remote, respiratory consultations should all be considered. To support this programme we have additionally established a Patient Advisory Group, in parallel to the ERG, to: a) support ongoing dialogue between the team and PPI infrastructure established previously, and b) strengthen community-research partnerships and joint stakeholder working. We are using innovative approaches to involve voices from 'hard-to-reach' populations in the current programme. Discussion: Considering different patient-focussed interaction modalities might help improve patient engagement and potentially increase (supported) self-management of asthma, especially in areas of diverse ethnicities or high deprivation. The insights from the ERG have proved valuable in shaping our approach to the three components of the PACE study: fine-tuning the search strategy for the Rapid Realist Review, confirming the factors for the Clinical Practice Research Datalink analysis, and suggesting topics for exploration in the qualitative interviews.